Feasibility Trial for a Right Ventricular Failure Platform Trial

Ki vehet részt

• Age ≥ 18 years
• Able to provide informed consent
• Able to comply with all study procedures
• History of RV dysfunction or RHF secondary to any of:; Group 1 PH, pulmonary arterial hypertension b. Group 2 PH, left heart disease with normal left ventricular ejection fraction (LVEF) > 50% and a previous RHC demonstrating combined pre and post-capillary PH, defined as: i. mPAP >20 mmHg ii. PAWP > 15 mmHg iii. PVR> 2 WU c. Group 3 PH d. Group 4 PH, chronic thromboembolic PH that is either persistent after pulmonary endarterectomy or inoperable due to distal disease
• Symptomatic with current NYHA Functional Class II-IV
• Biomarker and 2D echocardiogram evidence of RV dysfunction within 3 months:; NT-proBNP >300 ng/L and qualitative evidence of at least 'mild' RV dysfunction on echocardiography OR NT-proBNP<300 ng/L and qualitative evidence of at least moderate RV dysfunction and/or dilatation on 2D echocardiogram AND; A quantitative 2D echocardiogram with evidence of RV dysfunction defined as having both of the following:; TAPSE ≤18 mm ii. RV dilatation (RV diameter > 42 mm at the base)
• Receiving loop diuretics or mineralocorticoid receptor antagonists for at least 4 weeks
• Access to an iOS or android smart phone or tablet

Ki nem vehet részt

• Concurrent treatment with:; strong inhibitors of Cytochrome P450 3A4 (CYP 3A4), (e.g., ketoconazole, itraconazole, voriconazole, posaconazole, clarithromycin, nelfinavir, ritonavir, indinavir, saquinavir and grapefruit juice); class IA antiarrhythmics (e.g., quinidine, procainamide, disopyramide) or class III antiarrhythmics (e.g., sotalol, ibutilide, amiodarone, dronedarone); inducers of CYP 3A4 (e.g., rifampin, rifabutin, rifapentine, phenobarbital, phenytoin, carbamazepine, and St. John's wort)
• Severe aortic or mitral valvular disease
• Listed for lung, heart or heart/lung transplantation
• Myocardial infarction or acute coronary syndrome within 90 days of screening
• Planned cardiac or thoracic surgical intervention in the next 6 months
• Known hypersensitivity to empagliflozin or ranolazine
• Estimated glomerular filtration rate (eGFR) <30 ml/min
• LVEF < 50%
• Congenital long QT syndrome or a QTc interval >500 ms
• Normal RV size and function
• Moderate or severe hepatic dysfunction (Child-Pugh Class B or C)
• Participants requiring augmentation of diuretics or otherwise not meeting definition for clinical stability
• Pregnancy or lactation
• Unable to provide consent and comply with follow-up visits
• Enrolled in another interventional trial