Actively Recruiting

Phase Not Applicable
Age: 18Years +
All Genders
NCT04768322

LVAD Versus GDMT in Ambulatory Advanced Heart Failure Patients

Led by Hospices Civils de Lyon · Updated on 2026-05-08

92

Participants Needed

8

Research Sites

414 weeks

Total Duration

On this page

AI-Summary

What this Trial Is About

Heart failure is a severe disease affecting approximately 1-2% of the adult population in developed countries and around 26 million people worldwide. Up to 10% of these patients are in advanced stage heart failure, which is defined by a significant morbimortality and considerable medical expenses. Despite advances in its medical management, advanced (or end stage) heart failure is characterized by refractoriness to conventional therapies including guideline-directed pharmacological and non-surgical device treatments. These patients remain severely symptomatic (NYHA IV) and have objective signs of congestion or low cardiac output. Left ventricular assist devices (LVADs) have been used in patients with heart failure with reduced ejection fraction for almost 20 years either as an alternative or a bridge to heart transplantation. LVADs improve heart failure symptoms and survival at the cost of increased rates of infection, stroke and bleeding. Despite the lack of evidence, LVAD implantation in ambulatory patients is not rare, with INTERMACS profiles ≥4 patients representing 15.7% of the overall population implanted between 2012 and 2016. The aim of this study is to investigate the efficacy and safety of left ventricular assist devices compared to traditional HF medical treatment alone in a population of ambulatory advanced heart failure patients. Secondary objectives are to better identify subgroups of patients that would benefit the most from the implantation of an LVAD as well as to assess the optimal timing of intervention.

CONDITIONS

Official Title

LVAD Versus GDMT in Ambulatory Advanced Heart Failure Patients

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Age 18 years or older
  • Diagnosed with end-stage heart failure confirmed by a local Heart Team
  • Left ventricular ejection fraction of 35% or less within 1 week before randomization
  • Cardiac Index below 2.2 L/min/m2 within 1 month prior to randomization or VO2 max less than 14 ml/kg/min or under 50% of predicted VO2 max within 1 month prior to randomization, or a 6-minute walking test distance under 420 meters within 1 month prior to randomization, or at least 2 hospitalizations for heart failure in the past year
  • New York Heart Association (NYHA) class III or IV symptoms (INTERMACS profile 4-6)
  • Receiving optimal doses of beta-blockers, ACE inhibitors or Angiotensin II Receptor Blockers or angiotensin receptor neprilysin inhibitor (if eligible), mineralocorticoid receptor antagonists, and SGLT2 inhibitors for at least 45 days if tolerated
  • Receiving cardiac resynchronization therapy and/or implantable cardioverter defibrillators if indicated for at least 45 days
  • No mechanical circulatory support or inotrope therapy in the past 30 days
  • Have health coverage
  • Signed written informed consent
  • Not under any legal protection measure
Not Eligible

You will not qualify if you...

  • Inotrope dependent or receiving mechanical circulatory support within the last 30 days
  • Right ventricular dysfunction with expected need for Bi-VAD support
  • Currently pregnant or female of childbearing age not using contraception
  • Active infection
  • Irreversible end-organ dysfunction before LVAD implantation
  • Contraindication to anticoagulant or antiplatelet therapies
  • History of any organ transplant prior to inclusion
  • Psychiatric disease, irreversible cognitive dysfunction, or psychosocial issues likely to impair compliance
  • Frailty as determined by the heart team
  • Platelet count less than 100,000 per microliter
  • Body surface area less than 1.2 m2
  • Any non-heart failure condition expected to limit survival to less than 24 months
  • Chronic renal insufficiency with GFR less than 30 ml/min or hepatic cirrhosis
  • Participation in any other interventional clinical trial

AI-Screening

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Trial Site Locations

Total: 8 locations

1

CHU Besançon

Besançon, France

Actively Recruiting

2

Hôpital Pneumologique et Cardiovasculaire Louis Pradel

Bron, France

Actively Recruiting

3

CHU Caen

Caen, France

Actively Recruiting

4

La Tronche Hospital / CHU Grenoble

La Tronche, France

Actively Recruiting

5

Arnaud de Villeneuve Hospital / CHU Montpellier

Montpellier, France

Actively Recruiting

6

CHU Rouen

Rouen, France

Actively Recruiting

7

CHU Tours

Tours, France

Actively Recruiting

8

CHRU, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu

Vandœuvre-lès-Nancy, France

Actively Recruiting

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Research Team

G

Guillaume BAUDRY, Dr

CONTACT

G

Géraldine SAMSON

CONTACT

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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