Congestive Heart Failure

Spinal anesthesia-induced hypotension is a common and significant complication affecting up to 50-80% of pregnant women undergoing elective cesarean section. This trial evaluates whether a brief 5-minute mindfulness-based breathing exercise given just before spinal anesthesia can influence blood pressure changes during surgery. The study compares this breathing technique to standard care in pregnant women aged 18 to 45 years scheduled for elective cesarean delivery. Participants will be randomly assigned to either perform the mindfulness-based breathing exercise or receive standard preoperative care. The breathing exercise involves slow diaphragmatic breathing at about six breaths per minute, guided by a trained anesthesiologist or nurse, with mindful repetition of the phrase "My body is relaxing as I exhale." Both groups receive spinal anesthesia with specific medications, and careful monitoring of heart rate and blood pressure is performed. During the study, participants will be closely observed for changes in systolic blood pressure and heart rate within 10 minutes after spinal anesthesia. Anxiety levels, incidence of early hypotension, and medication use to support blood pressure will also be measured. The trial includes standard monitoring such as ECG and oxygen saturation, with safety and response data collected throughout the procedure. Participants' involvement includes a short breathing exercise or equivalent wait time before anesthesia, with follow-up assessments during surgery.

Researchers are studying the long-term effects of reducing household air pollution (HAP) from biomass fuel use on heart, lung, and immune health among women and children in semi-rural Bangladesh. The study evaluates whether a mobile phone-based behavioral change communication (mHealth BCC) intervention can increase the adoption and exclusive use of cleaner cooking fuel, Liquid Petroleum Gas (LPG). This research also investigates how lowering pollution exposure might influence immune responses to vaccines and subclinical cardiovascular and pulmonary changes. The study is a large household-level randomized controlled trial comparing two groups: one receiving the mHealth BCC intervention encouraging exclusive LPG use and a control group receiving no such intervention. Researchers will monitor personal and area levels of air pollutants like PM2.5 and black carbon before and after intervention, alongside detailed assessments including spirometry, chest X-rays, high-resolution CT scans, blood pressure, EKG, metabolic markers such as HbA1c and lipid profiles, and immune cell function. The intervention messages are delivered via mobile phone with frequency tailored to participant responses. Participants will be followed over two years with repeated measurements to assess pollutant exposure and health effects. Evaluations include lung function tests, imaging, cardiovascular markers, metabolic blood tests, and immune function assays. The study aims to provide insights into the health benefits of sustained LPG use and improved air quality. Total participation spans pre-intervention assessments through two years of follow-up, with ongoing monitoring of pollution exposure and health outcomes.

Heart failure is a leading cause of hospital admission in Ghana, accounting for about 88.3% of cardiac cases. Despite advances in treatment guidelines, many patients face repeated hospital readmissions, which increase the risk of death. This research aims to evaluate whether extensive counseling after discharge combined with regular phone follow-ups can reduce the rate of hospital readmissions within 30 and 90 days for heart failure patients at a major hospital in Ghana. The study compares two groups of heart failure patients: one receiving usual care, which includes counseling by their attending physicians and standard outpatient reviews, and another receiving additional extensive post-discharge counseling from a study doctor, pharmacist, or trained nurse, along with weekly phone follow-ups for the first 30 days and then every four weeks up to day 90. This approach aims to provide more support after hospital discharge to help reduce readmissions. Participants will be monitored over a 90-day period after discharge, with regular assessments through phone calls and outpatient visits. Researchers will track hospital readmission rates at both 30 and 90 days as the primary outcome. The study involves collecting information on patient adherence to treatment and follow-up care, aiming to better understand how enhanced support can impact heart failure management and reduce repeat hospitalizations.

The trial investigates the use of 3D transesophageal echocardiography (TEE) to analyze the right ventricle's function in patients undergoing left ventricular assist device (LVAD) implantation. LVADs help support the left ventricle in patients with severe heart failure. Because right ventricular failure after LVAD implantation is common and linked to complications, this study aims to better predict which patients are at higher risk by using advanced 3D imaging methods. Participants receive one of several types of left-sided LVADs, including HeartMate III, HeartWare HVAD, or Levitronix CentriMag devices. During the LVAD implantation procedure, 3D TEE images of the right ventricle are taken and analyzed. The study focuses on gathering detailed heart function data and does not involve additional treatments or interventions beyond standard device implantation. During the study, researchers collect various heart function measurements within 24 hours after implantation, such as ventricular strain, volumes, ejection fractions, and tricuspid annular plane systolic excursion. Secondary outcomes include monitoring clinical data and lab tests over 14 days post-implantation. Participants are observed for right ventricular function and related support needs. The study started in March 2022 and will continue through January 2027, involving no experimental treatments beyond imaging and data collection.

Researchers are investigating myocardial fibrosis in patients with heart failure, focusing on those with non-ischemic dilated cardiomyopathy (HFrEF phenotype) and hypertrophic cardiomyopathy (a subtype of HFpEF). The study explores the use of gallium-68-labeled fibroblast activation protein inhibitor positron emission tomography/computed tomography (68Ga-FAPI PET/CT) compared to the current standard, cardiac magnetic resonance imaging (CMR), to better detect and monitor fibrosis activity. This observational pilot study aims to improve non-invasive methods for assessing fibrogenesis and treatment effects. Participants will undergo 68Ga-FAPI PET/CT scans to evaluate myocardial fibrosis. The study includes patients with preserved or reduced left ventricular ejection fraction meeting specific imaging and diagnostic criteria. Recent echocardiograms, cardiac magnetic resonance imaging, and normal coronary angiogram or CT coronary angiography are required within specified timelines. The study is single-center and prospective, focusing on developing new assessment methodologies for future anti-fibrotic therapies. During the study, participants will be monitored through imaging assessments at baseline and after two years to measure 68Ga-FAPI uptake. Researchers will also correlate imaging findings with serum cardiac biomarkers and cardiovascular events. The study requires participants to have stable conditions without recent hospitalizations for heart failure and includes safety monitoring concerning kidney function and tolerance to procedures. The total participation duration may span over two years with repeated evaluations.

Researchers are studying how blood flow to muscles is controlled and how this changes with age and certain diseases such as chronic obstructive pulmonary disease (COPD), sepsis, pulmonary hypertension, and cardiovascular disease. The study focuses on four key pathways that affect blood vessel constriction and dilation: Angiotensin-II, Endothelin-1, Nitric Oxide, and oxidative stress. The goal is to better understand how these pathways contribute to reduced blood flow during exercise and whether these changes can be improved. Participants will receive various treatments including exercise tests and drugs that affect blood vessel function, such as Nitric Oxide blockers, antioxidants, receptor antagonists, and other vasoactive agents. These treatments will be given through catheter placements for measurements and infusions. Different groups include healthy young adults, older adults, and patients with conditions like COPD, pulmonary arterial hypertension, heart failure, and hypertension. The study will also evaluate effects before and after exercise training. During the study, participants will undergo tests such as maximum exercise capacity, measurements of blood flow, blood pressure, muscle metabolism, and muscle fatigue using advanced imaging techniques like Nuclear Magnetic Resonance (NMR). Researchers will monitor changes in limb blood flow and other outcomes at baseline and one hour after treatments. The study aims to provide detailed insight into how vascular function changes with age and disease and how it responds to various interventions over time.

Researchers are evaluating a new 10-minute cardiovascular magnetic resonance (CMR) imaging protocol designed to improve current CMR procedures for patients with various heart conditions, including coronary artery disease, cardiomyopathies, and other cardiac diseases. The study aims to develop a standardized, contrast-free imaging method that can be applied to about 70% of cardiac patients. The goal is to assess whether this shorter protocol enhances diagnostic decision-making and reduces healthcare costs. The study involves two groups: healthy volunteers over 18 years old without significant cardiovascular or respiratory conditions, and patients over 18 years who require a clinically indicated CMR exam. The new protocol focuses on heart function and tissue characterization without using contrast agents. Researchers will compare the new 10-minute protocol to standard CMR imaging, evaluating its clinical feasibility, performance, and cost-effectiveness in different patient populations. Participants will undergo CMR scans using both the new and standard protocols. Researchers will monitor diagnostic results, scan completion rates, scan sequence times, adverse events, and cost differences between methods. Various heart tissue measurements and reproducibility between different readers and scanners will also be assessed. The study spans from 2019 to 2025, with ongoing safety monitoring during imaging sequences and a focus on improving the efficiency and quality of cardiac imaging.

Researchers are evaluating the safety, tolerability, pharmacokinetics, and pharmacodynamics of HRS-5765 in healthy adults aged 18 to 65 years. This phase I randomized, double-blind study also explores how food affects HRS-5765's pharmacokinetics and its impact on certain metabolic enzymes. The trial is sponsored by Chengdu Suncadia Medicine Co., Ltd. and focuses on healthy volunteers without significant health issues. Participants will be randomly assigned to receive either a specified dose of HRS-5765 tablet or a matching placebo. The study includes single and multiple oral dosing periods, with dose escalation across cohorts. The trial includes a food effect period to assess medication behavior with meals. Treatments are given orally, and participants remain blinded to their assigned group throughout the trial. During the study, participants are closely monitored for adverse events and serious adverse events from day 1 through day 21, depending on the dosing period. Researchers will measure drug levels in the blood, including maximum concentration, time to reach this level, overall exposure, and clearance from the body over 18 days. Safety assessments, laboratory tests, physical exams, and adherence to diet and contraception requirements are also conducted. The total study duration varies by participant depending on dosing and follow-up periods.

Researchers are evaluating the effects of a sequential "lying-sitting-standing" Baduanjin exercise on patients who have acute coronary syndrome complicated by heart failure. The study aims to compare this intervention with conventional treatment by assessing heart and lung function as well as quality of life. Key measures include echocardiography, NT-proBNP levels, a six-minute walk test, NYHA classification, and the SF-36 health survey, with the goal of improving early cardiac rehabilitation strategies for these patients. Participants will be randomly assigned to either receive standard treatment with routine rehabilitation nursing guidance or to practice the "lying-sitting-standing" sequential Baduanjin exercise. The intervention lasts 12 weeks, during which researchers will monitor several health indicators and functional assessments. This double-blind study compares these two behavioral approaches to determine their impact on cardiopulmonary function and patient well-being. During the 12-week treatment, participants will undergo evaluations including the six-minute walk test, assessment of heart function by echocardiography, measurement of blood markers such as NT-proBNP and C-reactive protein, and quality of life surveys like the SF-36. Additional assessments include flow-mediated vasodilation and activities of daily living scales. These tests will help researchers measure changes in heart function, physical ability, and overall health status throughout the study period.

Researchers are evaluating the use of sodium zirconium cyclosilicate (SZC) to help optimize renin-angiotensin aldosterone system inhibitor (RAASi) therapies in elderly patients aged 70 and older who have heart failure and chronic kidney disease. Many patients with these conditions do not receive recommended RAASi doses because of elevated potassium levels, which can be dangerous. This study aims to see if adding SZC allows safer and more effective use of RAASi medications by managing potassium levels. This is a randomized, open-label clinical trial where eligible participants who have been hospitalized for heart failure worsening and have mild or at-risk hyperkalemia will be assigned to one of two groups. One group receives SZC along with standard RAASi treatment, while the other receives RAASi treatment alone without potassium binders. The treatment period lasts three months, during which RAASi doses are adjusted following European Society of Cardiology guidelines. Participants will be monitored from screening through three months of treatment to measure how many can increase their RAASi doses by at least 25%. Evaluations include clinical assessments, potassium level monitoring, and adherence to therapy. The study will also track secondary outcomes related to higher dose increases. Safety and treatment effects will be observed throughout the trial, which is expected to provide important insights for managing these conditions in elderly patients.