Hemodynamic-GUIDEd Management of Heart Failure

NCT ID: NCT03387813

Last Updated: 2025-08-07

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

2358 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-03-15

Study Completion Date

2023-05-17

Brief Summary

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The GUIDE-HF IDE clinical trial is intended to demonstrate the effectiveness of the CardioMEMS™ HF System in an expanded patient population including heart failure (HF) patients outside of the present indication, but at risk for future HF events or mortality.

Detailed Description

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The GUIDE-HF IDE clinical trial is intended to demonstrate the effectiveness of the CardioMEMS™ HF System in an expanded patient population including HF patients outside of the present indication, but at risk for future HF events or mortality.

The trial includes patients with New York Heart Association (NYHA) Class II, III, or IV HF who have an elevated N-terminal pro-Brain Natriuretic Peptide (NT-proBNP) (or an elevated Brain Natriuretic Peptide (BNP)) and/or a prior HF hospitalization (HFH).

The GUIDE-HF IDE trial will include approximately 3600 subjects at approximately 140 North American sites and consists of two arms: a Randomized Arm and a Single Arm.

Conditions

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Heart Failure Heart Failure, Systolic Heart Failure, Diastolic Heart Failure NYHA Class II Heart Failure NYHA Class III Heart Failure NYHA Class IV Heart Failure,Congestive Heart Failure With Reduced Ejection Fraction Heart Failure With Normal Ejection Fraction Heart Failure; With Decompensation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Randomized Arm - Treatment Group

Management of subjects based on pulmonary artery (PA) pressure information derived from the CardioMEMS™ HF System.

All subjects will receive a CardioMEMS™ HF System.

Group Type EXPERIMENTAL

CardioMEMS™ HF System

Intervention Type DEVICE

The CardioMEMS™ HF System is comprised of a lead-less, battery-less pressure sensor permanently implanted in the PA, which remotely transmits PA pressure measurements from the patient's home to a secure website. Healthcare professionals are able to access these measurements and associated waveforms to remotely guide individualization of medical management for their patients with chronic HF.

Randomized Arm - Control Group

Management of subjects per standard of care (signs, symptoms, weight etc.) without knowledge of PA pressure information derived from the CardioMEMS™ HF System.

All subjects will receive a CardioMEMS™ HF System.

Group Type EXPERIMENTAL

CardioMEMS™ HF System

Intervention Type DEVICE

The CardioMEMS™ HF System is comprised of a lead-less, battery-less pressure sensor permanently implanted in the PA, which remotely transmits PA pressure measurements from the patient's home to a secure website. Healthcare professionals are able to access these measurements and associated waveforms to remotely guide individualization of medical management for their patients with chronic HF.

Single Arm

Management of subjects based on PA pressure information derived from the CardioMEMS™ HF System.

All subjects will receive a CardioMEMS™ HF System.

Group Type EXPERIMENTAL

CardioMEMS™ HF System

Intervention Type DEVICE

The CardioMEMS™ HF System is comprised of a lead-less, battery-less pressure sensor permanently implanted in the PA, which remotely transmits PA pressure measurements from the patient's home to a secure website. Healthcare professionals are able to access these measurements and associated waveforms to remotely guide individualization of medical management for their patients with chronic HF.

Interventions

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CardioMEMS™ HF System

The CardioMEMS™ HF System is comprised of a lead-less, battery-less pressure sensor permanently implanted in the PA, which remotely transmits PA pressure measurements from the patient's home to a secure website. Healthcare professionals are able to access these measurements and associated waveforms to remotely guide individualization of medical management for their patients with chronic HF.

Intervention Type DEVICE

Other Intervention Names

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CardioMEMS CardioMEMS PA Sensor CardioMEMS HF System

Eligibility Criteria

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Inclusion Criteria

1. Diagnosis and treatment for heart failure (HF) (regardless of left ventricular ejection fraction (LVEF)) for \> 90 days prior to the date of consent:

a. Subjects should be on stable, optimally titrated medical therapy for at least 30 days, as recommended according to current American Heart Association (AHA)/American College of Cardiology (ACC) guidelines as standard-of-care for HF therapy in the United States, with any intolerance documented.
2. GUIDE-HF Randomized Arm Only: NYHA Class II, III or IV HF symptoms documented within 30 days prior to consent.
3. GUIDE-HF Single Arm Only: NYHA Class III HF symptoms documented within 30 days prior to consent.
4. HF hospitalization (HFH) within 12 months prior to consent and/or elevated N-terminal pro-Brain Natriuretic Peptide (NT-proBNP) (or Brain Natriuretic Peptide (BNP)) within 30 days prior to consent defined as:

1. Subjects with LVEF ≤ 40%: NT-proBNP ≥ 1000 pg/mL (or BNP ≥ 250 pg/mL).
2. Subjects with LVEF \> 40%: NT-proBNP ≥ 700 pg/mL (or BNP ≥ 175 pg/mL).
3. Thresholds for NT-proBNP and BNP (for both LVEF ≤ 40% and LVEF \> 40%) will be corrected for body mass index (BMI) using a 4% reduction per BMI unit over 25 kg/m2
5. ≥ 18 years of age
6. Chest circumference of \< 65 inches, if BMI is \> 35 kg/m2
7. Written informed consent obtained from subject
8. Willing and able to upload pulmonary artery (PA) pressure information and comply with the follow-up requirements

Exclusion Criteria

1. Intolerance to all neuro-hormonal antagonists (i.e., intolerance to angiotensin converting enzyme-inhibitors (ACE-I), angiotensin receptor blockers (ARB), angiotensin-neprilysin inhibitors (ARNi), hydralazine/isosorbide dinitrate and beta-blockers)
2. ACC/AHA Stage D refractory HF (including having received or currently receiving pharmacologic circulatory support with inotropes)
3. Received or are likely to receive an advanced therapy (e.g., mechanical circulatory support or cardiac transplant) in the next 12 months
4. NYHA Class IV HF patients with:

1. Continuous or chronic use of scheduled intermittent inotropic therapy for HF and an INTERMACS level of ≤ 4, OR
2. Persistence of fluid overload with maximum (or dose equivalent) diuretic intervention
5. Glomerular Filtration Rate (eGFR) \< 25 mL/min and non-responsive to diuretic therapy, or receiving chronic dialysis
6. Inability to tolerate or receive dual antiplatelet therapy or anticoagulation therapy for one month post-implantation
7. Significant congenital heart disease that has not been repaired and would prevent implantation of the CardioMEMS™ PA Sensor
8. Implanted with mechanical right heart valve(s)
9. Unrepaired severe valvular disease
10. Pregnant or planning to become pregnant in the next 12 months
11. An active, ongoing infection, defined as being febrile, an elevated white blood cell count, on intravenous antibiotics, and/or positive cultures (blood, sputum or urine).
12. History of current or recurrent (≥ 2 episodes within 5 years prior to consent) pulmonary emboli and/or deep vein thrombosis
13. Major cardiovascular event (e.g., unstable angina, myocardial infarction, percutaneous coronary intervention, open heart surgery, or stroke, etc.) within 90 days prior to consent
14. Implanted with Cardiac Resynchronization Therapy (CRT)-Pacemaker (CRT-P) or CRT-Defibrillator (CRT-D) for less than 90 days prior to consent
15. Enrollment into another trial with an active treatment arm
16. Anticipated life expectancy of \< 12 months
17. Any condition that, in the opinion of the Investigator, would not allow for utilization of the CardioMEMS™ HF System to manage the subject using information gained from hemodynamic measurements to adjust medications, including the presence of unexpectedly severe pulmonary hypertension (e.g., trans-pulmonary gradient \>15) at implant right heart catheterization (RHC), a history of non-compliance, or any condition that would preclude CardioMEMS™ PA Sensor implantation
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Abbott Medical Devices

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Nessa Johnson, PhD

Role: STUDY_DIRECTOR

Abbott

Locations

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Banner-University Medical Center Phoenix

Phoenix, Arizona, United States

Site Status

Arizona Cardiovascular Research Center

Phoenix, Arizona, United States

Site Status

Phoenix Cardiovascular Research Group

Phoenix, Arizona, United States

Site Status

University of Arizona

Tucson, Arizona, United States

Site Status

Washington Regional Medical Center

Fayetteville, Arkansas, United States

Site Status

Baptist Health Medical Center

Little Rock, Arkansas, United States

Site Status

Arkansas Heart Hospital

Little Rock, Arkansas, United States

Site Status

John Muir Medical Center

Concord, California, United States

Site Status

Adventist Health St. Helena

Deer Park, California, United States

Site Status

Scripps Health

La Jolla, California, United States

Site Status

University of California at San Diego (UCSD) Medical Center

La Jolla, California, United States

Site Status

USC University Hospital

Los Angeles, California, United States

Site Status

Ronald Reagan UCLA Medical Center

Los Angeles, California, United States

Site Status

Eisenhower Medical Center

Rancho Mirage, California, United States

Site Status

Sutter Medical Center, Sacramento

Sacramento, California, United States

Site Status

Mercy Medical Group - Cardiology

Sacramento, California, United States

Site Status

San Diego Cardiac Center

San Diego, California, United States

Site Status

California Pacific Medical Center - Van Ness Campus

San Francisco, California, United States

Site Status

Ventura Cardiology Consultants

Ventura, California, United States

Site Status

University of Colorado Hospital

Aurora, Colorado, United States

Site Status

North Colorado Medical Center

Greeley, Colorado, United States

Site Status

South Denver Cardiology Associates PC

Littleton, Colorado, United States

Site Status

Hartford Hospital

Hartford, Connecticut, United States

Site Status

Yale New Haven Hospital

New Haven, Connecticut, United States

Site Status

George Washington University Hospital

Washington D.C., District of Columbia, United States

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Bethesda Memorial Hospital

Boynton Beach, Florida, United States

Site Status

Morton Plant Hospital

Clearwater, Florida, United States

Site Status

Memorial Regional Hospital

Hollywood, Florida, United States

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First Coast Cardiovascular Institute

Jacksonville, Florida, United States

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Memorial Hospital Jacksonville

Jacksonville, Florida, United States

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Advent Health Orlando

Orlando, Florida, United States

Site Status

Tampa General Hospital

Tampa, Florida, United States

Site Status

Piedmont Athens Regional Medical Center

Athens, Georgia, United States

Site Status

University Hospital

Augusta, Georgia, United States

Site Status

WellStar Kennestone Hospital

Marietta, Georgia, United States

Site Status

Northshore University HealthSystem

Evanston, Illinois, United States

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Advocate Health and Hospitals Corporation

Oakbrook Terrace, Illinois, United States

Site Status

St. Vincent Hospital

Indianapolis, Indiana, United States

Site Status

Heart Center of Lake County

Merrillville, Indiana, United States

Site Status

Iowa Heart Center

West Des Moines, Iowa, United States

Site Status

Kansas University Medical Center

Kansas City, Kansas, United States

Site Status

Cardiovascular Research Institute of Kansas

Wichita, Kansas, United States

Site Status

Our Lady of the Lake Hospital

Baton Rouge, Louisiana, United States

Site Status

Cardiovascular Institute of the South

Houma, Louisiana, United States

Site Status

Louisiana State University Health Sciences Center

New Orleans, Louisiana, United States

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Ochsner Medical Center

New Orleans, Louisiana, United States

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Advanced Cardiovascular Specialists

Shreveport, Louisiana, United States

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Brigham and Women's Hospital

Boston, Massachusetts, United States

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University of Massachusetts

Worcester, Massachusetts, United States

Site Status

University of Michigan

Ann Arbor, Michigan, United States

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McLaren Health Care Corporation

Auburn Hills, Michigan, United States

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Henry Ford Hospital

Detroit, Michigan, United States

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MidMichigan Medical Center-Midland

Midland, Michigan, United States

Site Status

Providence Hospital

Southfield, Michigan, United States

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Minneapolis Heart Institute

Minneapolis, Minnesota, United States

Site Status

University of Minnesota Medical Center Fairview

Minneapolis, Minnesota, United States

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Mayo Clinic

Rochester, Minnesota, United States

Site Status

St. Cloud Hospital

Saint Cloud, Minnesota, United States

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St. Luke's Hospital

Kansas City, Missouri, United States

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North Kansas City Hospital

North Kansas City, Missouri, United States

Site Status

Mercy Hospital St. Louis

St Louis, Missouri, United States

Site Status

BryanLGH Heart Institute

Lincoln, Nebraska, United States

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University of Nebraska Medical Center

Omaha, Nebraska, United States

Site Status

Renown Regional Medical Center

Reno, Nevada, United States

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Catholic Medical Center

Manchester, New Hampshire, United States

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Deborah Heart and Lung Center

Browns Mills, New Jersey, United States

Site Status

Saint Barnabas Medical Center

Livingston, New Jersey, United States

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Lourdes Cardiology Services

Voorhees Township, New Jersey, United States

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New Mexico Heart Institute

Albuquerque, New Mexico, United States

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New York University Hospital

New York, New York, United States

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Mount Sinai Hospital

New York, New York, United States

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New York-Presbyterian/Columbia University

New York, New York, United States

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Hudson Valley Cardiovascular Practice, P.C.

Poughkeepsie, New York, United States

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Rochester General Hospital

Rochester, New York, United States

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St. Francis Hospital

Roslyn, New York, United States

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Carolinas Medical Center

Charlotte, North Carolina, United States

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Vidant Medical Center

Greenville, North Carolina, United States

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NC Heart and Vascular Research

Raleigh, North Carolina, United States

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WakeMed Hospital

Raleigh, North Carolina, United States

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Akron City Hospital

Akron, Ohio, United States

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University Hospitals Cleveland Medical Center

Cleveland, Ohio, United States

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The Cleveland Clinic Foundation

Cleveland, Ohio, United States

Site Status

Ohio State University

Columbus, Ohio, United States

Site Status

Ohio Health Research Institute

Columbus, Ohio, United States

Site Status

St. Elizabeth Health Center

Youngstown, Ohio, United States

Site Status

Integris Baptist Medical Center

Oklahoma City, Oklahoma, United States

Site Status

Oklahoma Heart Hospital South

Oklahoma City, Oklahoma, United States

Site Status

Oklahoma Heart Institute at Utica

Tulsa, Oklahoma, United States

Site Status

Providence Heart and Vascular

Portland, Oregon, United States

Site Status

Abington Memorial Hospital

Abington, Pennsylvania, United States

Site Status

Pinnacle Health System

Harrisburg, Pennsylvania, United States

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Penn State Milton S. Hershey Medical Center

Hershey, Pennsylvania, United States

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Lancaster General Hospital

Lancaster, Pennsylvania, United States

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Hospital of the University of Pennsylvania

Philadelphia, Pennsylvania, United States

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Albert Einstein Medical Center

Philadelphia, Pennsylvania, United States

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Allegheny General Hospital - ASRI

Pittsburgh, Pennsylvania, United States

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The Reading Hospital and Medical Center

West Reading, Pennsylvania, United States

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Main Line Health Center/Lankenau Hospital

Wynnewood, Pennsylvania, United States

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Rhode Island Hospital

Providence, Rhode Island, United States

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Prisma Health-Midlands

Columbia, South Carolina, United States

Site Status

Greenville Health System

Greenville, South Carolina, United States

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Sanford USD Medical Center

Sioux Falls, South Dakota, United States

Site Status

Tennova Healthcare - Turkey Creek Medical Center

Knoxville, Tennessee, United States

Site Status

Methodist University Hospital

Memphis, Tennessee, United States

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St Thomas Hospital

Nashville, Tennessee, United States

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Vanderbilt University Medical Center

Nashville, Tennessee, United States

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Acension Texas Cardiovascular

Austin, Texas, United States

Site Status

Austin Heart

Austin, Texas, United States

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Baylor University Hospital

Dallas, Texas, United States

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John Peter Smith Hospital

Fort Worth, Texas, United States

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Park Plaza Hospital

Houston, Texas, United States

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CHI St. Luke's Health Baylor College of Medicine Med. Ctr.

Houston, Texas, United States

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Memorial Hermann Hospital

Houston, Texas, United States

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The Methodist Hospital

Houston, Texas, United States

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Methodist Healthcare System of San Antonio

San Antonio, Texas, United States

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Virginia Heart - The Cardiovascular Group, P.C.

Falls Church, Virginia, United States

Site Status

Sentara Norfolk General Hospital

Norfolk, Virginia, United States

Site Status

Bon Secours Heart & Vascular Institute

Richmond, Virginia, United States

Site Status

Winchester Medical Center

Winchester, Virginia, United States

Site Status

Providence Everett Medical Center

Everett, Washington, United States

Site Status

Swedish Medical Center - Heart & Vascular

Seattle, Washington, United States

Site Status

University of Washington Medical Center

Seattle, Washington, United States

Site Status

Aurora Medical Group

Milwaukee, Wisconsin, United States

Site Status

Waukesha Memorial Hospital

Waukesha, Wisconsin, United States

Site Status

Aspirus Wausau Hospital

Wausau, Wisconsin, United States

Site Status

Foothills Medical Centre

Calgary, Alberta, Canada

Site Status

Vancouver General Hospital (U of BC)

Vancouver, British Columbia, Canada

Site Status

Southlake Regional Health Centre

Newmarket, Ontario, Canada

Site Status

Toronto General Hospital

Toronto, Ontario, Canada

Site Status

Countries

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United States Canada

References

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Zile MR, Abraham WT, Stevenson LW, Costanzo MR, Angermann CE, Mehra MR, Desai AS, Ducharme A, Johnson N, Henderson J, Lindenfeld J. Relationship Between Remote, Ambulatory Pulmonary Artery Pressures, and All-Cause Mortality in Patients With Chronic Heart Failure. Circ Heart Fail. 2025 Jun;18(6):e012754. doi: 10.1161/CIRCHEARTFAILURE.124.012754. Epub 2025 Apr 14.

Reference Type DERIVED
PMID: 40223608 (View on PubMed)

Desai AS, Maisel A, Mehra MR, Zile MR, Ducharme A, Paul S, Sears SF, Smart F, Bhatt K, Krim S, Henderson J, Johnson N, Adamson PB, Costanzo MR, Lindenfeld J; GUIDE-HF Investigators. Hemodynamic-Guided Heart Failure Management in Patients With Either Prior HF Hospitalization or Elevated Natriuretic Peptides. JACC Heart Fail. 2023 Jun;11(6):691-698. doi: 10.1016/j.jchf.2023.01.007. Epub 2023 Apr 12.

Reference Type DERIVED
PMID: 37286262 (View on PubMed)

Zile MR, Mehra MR, Ducharme A, Sears SF, Desai AS, Maisel A, Paul S, Smart F, Grafton G, Kumar S, Nossuli TO, Johnson N, Henderson J, Adamson PB, Costanzo MR, Lindenfeld J. Hemodynamically-Guided Management of Heart Failure Across the Ejection Fraction Spectrum: The GUIDE-HF Trial. JACC Heart Fail. 2022 Dec;10(12):931-944. doi: 10.1016/j.jchf.2022.08.012. Epub 2022 Oct 12.

Reference Type DERIVED
PMID: 36456066 (View on PubMed)

Zile MR, Desai AS, Costanzo MR, Ducharme A, Maisel A, Mehra MR, Paul S, Sears SF, Smart F, Chien C, Guha A, Guichard JL, Hall S, Jonsson O, Johnson N, Sood P, Henderson J, Adamson PB, Lindenfeld J. The GUIDE-HF trial of pulmonary artery pressure monitoring in heart failure: impact of the COVID-19 pandemic. Eur Heart J. 2022 Jul 14;43(27):2603-2618. doi: 10.1093/eurheartj/ehac114.

Reference Type DERIVED
PMID: 35266003 (View on PubMed)

Lindenfeld J, Zile MR, Desai AS, Bhatt K, Ducharme A, Horstmanshof D, Krim SR, Maisel A, Mehra MR, Paul S, Sears SF, Sauer AJ, Smart F, Zughaib M, Castaneda P, Kelly J, Johnson N, Sood P, Ginn G, Henderson J, Adamson PB, Costanzo MR. Haemodynamic-guided management of heart failure (GUIDE-HF): a randomised controlled trial. Lancet. 2021 Sep 11;398(10304):991-1001. doi: 10.1016/S0140-6736(21)01754-2. Epub 2021 Aug 27.

Reference Type DERIVED
PMID: 34461042 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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CIP-10170

Identifier Type: -

Identifier Source: org_study_id

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