A Study of AZD3427 in Participants With Heart Failure and Pulmonary Hypertension Group 2

Prior treatment

• Any known planned (scheduled) highly invasive Cardiovascular (CV) procedure (eg, coronary revascularisation, ablation of atrial fibrillation/flutter, valve repair/replacement, aortic aneurysm surgery, etc).
• Participants who have previously received AZD3427.

Other illness

• Historical or current evidence of a clinically significant disease or disorder.
• History of hypersensitivity to SC injections or devices.
• History of hypersensitivity to drugs with a similar chemical structure or class to AZD3427 or any component of AZD3427 drug product, or ongoing clinically important allergy/hypersensitivity.
• Known lung disease with Forced expiratory volume in the first second (FEV1) \< 30% of predicted.
• Cardiac ventricular arrhythmia which requires treatment. Participants with atrial fibrillation or flutter and controlled ventricular rate are permitted.
• History of or anticipated heart transplant or ventricular assist device implantation.

Lab values

• Congenital long QT syndrome.

Other

• Diagnosis of PH in World Health Organization (WHO) Group 1, WHO Group 3, WHO Group 4, or WHO Group 5.
• Decompensated HF or hospitalisation due to decompensated HF.
• Any contraindications to RHC.

• Participant must be ≥ 18 years of age inclusive.
• Participants must have a pre-existing diagnosis of HF, NYHA function class (FC) II to IV, and a pre-existing diagnosis of PH-LHD or likely or intermediate probability of Pulmonary hypertension due to left heart disease (PH-LHD) as per 2022 Pulmonary hypertension due to left heart disease European Society of Cardiology/European Respiratory Society (ESC/ERS) guidelines. Participants must be on stable HF standard of care medication, including diuretics.
• Participants must have a combination of echocardiographic parameters that show intermediate or high probability of PH as per 2022 ESC/ERS guidelines.
• Participants must have an on-study elevated pulmonary artery pressure from RHC performed as per RHC manual provided by the Sponsor, at Screening Visit 2:
  • PAWP ≥ 15 mmHg
  • mPAP ≥ 20 mmHg
• Minimum body weight of 45 kg (inclusive).
• Capable and willing of giving signed informed consent.