Review Article

New Insights in the Diagnosis and Treatment of Heart Failure

Table 2

Recent and ongoing studies in heart failure with preserved ejection fraction.

Study Type Drug/comp. Number of pts/Age Outcome Results

TOP-CAT Outcome Spironolactone versus placebo 3445/69 Primary outcome: CV death/HF hospitalization/aborted cardiac arrest In follow-up 3.3 years 18 versus 20 ()

Aldo-DHF PoC Spironolactone versus placebo 422/67 Coprimary outcomes:  
(i) Diastolic dysfunction (E/E′) 
(ii) Exercise capacity/peak VO2
In 12-month follow-up 
(i) 12.1 versus 13.6 () 
(ii) 16.8 versus 16.9 ()

RELAX PoC Sildenafil versus placebo 216/69 Primary outcome: 
exercise capacity/peak VO2 
Secondary outcome: 
(i) 6 min walk test 
(ii) Clinical outcome
In 24-week follow-up 
(i) −0.2 versus −0.2 () 
 (ii) 5.0 versus 15 m () 
(iii) 94 versus 95 ()

PARAMOUNT PoC LCZ 696 angiotensin rec. + Neprilysin inhib. versus valsartan 266/71 Change NT-proBNP 
Side effects
Ratio LCZ696/valsartan 0.77 () 
22 patients (15%) on LCZ696 versus 30 (20%) on valsartan

DHART PoC Anakinra versus placebo 12/62 Exercise capacity/peak VO2 +1.2 mL/kg/min (+8%, )

RALI-DHF PoC Ranolazine (iv 24 h infusion followed  by 13 days of oral treatment) 
versus placebo
20/73 Changes in hemodynamic parameters 
Changes in echocardiography, PeakVO2, and NT-proBNP parameters
LVEDP (mmHg) 23 versus 19 (); PCWP 18 versus 12 () 
No changes ()

Kosmala PoC Ivabradine versus placebo 61/67 Exercise capacity (METS) 
Peak VO2
+1.5 versus +0.4 () 
+3.0 versus +0.4 ()

PARAGON-HF Outcome LCZ956 versus valsartanCV death and HF Hospitalization Ongoing

SOCRATES-PRESERVEDPoC Vericiguat (guanylate cyclase stimulator)Change in NT-proBNP Ongoing

EDIFY Outcome Ivabradine versus placebo 400 Diastolic dysfunction (E/E′, exercise capacity, NT-proBNP)Ongoing

PoC, proof-of-concept.