Pilot Study to Assess the Safety and Efficacy of a Selective Cytopheretic Device (SCD) to Treat Patients With NYHA Stage III or IV Heart Failure (HF) With Persistent Congestion and Worsening Renal Function as a Result of Cardiorenal Syndrome (CRS) That is Resistant to Optimal Medical Therapy Including Loop Diuretics

Lenar Yessayan1 site in 1 country10 target enrollmentSeptember 2025

ConditionsHeart Failure Chronic Systolic Heart Failure Renal Failure Cardiorenal Syndrome

Overview

Phase: N/A
Intervention: Not specified
Conditions: Heart Failure
Sponsor: Lenar Yessayan
Enrollment: 10
Locations: 1
Primary Endpoint: Improvement in Cardiac Function - Left Ventricular Ejection Fraction
Status: Suspended
Last Updated: last year

Overview Investigators Eligibility Criteria Outcomes Sites Similar Trials

Overview

Brief Summary

The purpose of this clinical trial is to see if a new device (SCD) is safe and if it can reduce damage to the kidney enough to allow medications to work to improve heart and kidney function for use in patients that have moderate to severe heart failure and is at least in part due to heart failure and it not responding to standard medical therapy. The SCD is a cartridge used with a commercial hemodialysis unit.

Participants will be enrolled in the clinical trial once eligibility is confirmed. In addition to clinical assessments and laboratory testing participants will have surface echocardiograms during the trial. The SCD treatment will take place for 4 hours on day 1, 3, and 5 while on hemodialysis.

Registry

clinicaltrials.gov

Start Date

September 2025

End Date

December 2027

Last Updated

last year

Study Type

Interventional

Study Design

Single Group

Sex

All

Investigators

Sponsor

Lenar Yessayan

Responsible Party

Sponsor Investigator

Principal Investigator

Lenar Yessayan

Professor of Medicine

University of Michigan

Eligibility Criteria

Inclusion Criteria

•Primary hospitalization for acute decompensated chronic systolic heart failure as defined:
•Left ventricular ejection fraction ≤35% as confirmed by baseline imaging procedure.
•New York Heart Association (NYHA) class III or IV chronic (≤ 90 days) systolic heart failure, with failure to respond to optimal medical therapy (beta blocker, Angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blockers (ARB) or valsartan/sacubitril, aldosterone antagonist, unless not tolerated or contraindicated, and loop diuretic, as needed) for 45 of the last 60 days.
•Baseline Estimated Glomerular Filtration Rate (eGFR)\*\* ≥ 40 ml/min/1.73 m2 (baseline defined as the highest known eGFR within 90 days of study enrollment)
•Worsening renal failure (WRF), defined for the purposes of this study as increase serum creatinine ≥ 0.5 mg/dL from baseline (baseline defined as the lowest known serum creatinine within 90 days of study enrollment)
•Cardiorenal syndrome is the most likely explanation for WRF
•Persistent signs and /or symptoms of congestion (peripheral edema, dyspnea, pulmonary rales, neck vein distension) despite optimal medical therapy including intravenous diuretic therapy and an estimated need for greater than 5 kg. of fluid removal. For the purposes of this study, optimal intravenous diuretic therapy is defined as:
•Furosemide equivalent total daily dose of 240 mg (furosemide 40mg=1mg bumetanide)
•Furosemide equivalent dose given either as a single or multiple intravenous bolus or continuous infusion
•A furosemide equivalent total daily dose \<240 mg if the dose has resulted in \>3000 ml urine output/24 hours

Exclusion Criteria

•Prior sensitivity to dialysis device components
•Individual with known hypersensitivity to citrate
•Bacteremia or possible infection, as evidence by fever, white blood cell count \> 10,000/microliter, or any other signs of acute or chronic infection, and any patient receiving antibiotic or antiviral therapy.
•Active malignancy requiring chemotherapy, biological therapy or radiation therapy.
•The use of intravenous iodinated contrast agent within the prior 72 hours or the anticipated use of such an agent during SCD therapy.
•Need for intravenous vasopressor (i.e., phenylephrine, vasopressin), intravenous. vasoconstricting inotrope (i.e., norepinephrine or epinephrine) or dopamine \> 3 mcg/kg/min. (Note: use of vasodilating inotropes \[i.e., dobutamine and milrinone\] or dopamine at ≤ 3 mcg/kg/min will not preclude study inclusion).
•Persistent systolic blood pressure (SBP) \< 80 mmHg.
•White blood cell (WBC)\<4000/microliter.
•Platelets \< 50,000/microliter.
•Serum creatinine \> 4 mg/dL or receiving dialysis / continuous renal replacement therapy (CRRT)

Outcomes

Primary Outcomes

Improvement in Cardiac Function - Left Ventricular Ejection Fraction

Time Frame: up to 4 weeks following last SCD treatment

This will be assessed by surface echocardiography.

Secondary Outcomes

Improved renal function as measured by serum creatinine(up to 4 weeks following the last SCD therapy)
Improved renal function as measured by blood urea nitrogen (BUN)(up to 4 weeks following the last SCD therapy)