Using Polygenic Scores to Guide Beta-blocker Therapy for Heart Failure With Mildly Reduced Ejection Fraction
David Lanfear
Summary
This study will use polygenic scores, a tool which describes differences in genetics, to examine effectiveness of beta blocker medication in heart failure patients with ejection fraction of 41-50 percent. The study will also assess beta blockers' effect on the changes in left ventricular end-systolic volume index by MRI.
Description
Heart failure (HF) is a major public health problem that displays wide variation in progression and response to therapy. Beta-blockers (BB) are the cornerstone of treatment for HF reduced ejection fraction (HFrEF) but only \~25% of patients experience a marked and sustained ejection fraction (EF) response, and they can have unwanted side effects (fatigue, depression, erectile dysfunction, others). The potential for Precision Medicine to improve HF care is great, but despite proof of concept, actionable ways are still lacking to use genomic or biomarker strategies to predict response to typical…
Eligibility
- Age range
- 18–89 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Age 18-89 years * Ejection Fraction (EF) \>40% and =\<50% by any modality within 1 year (must be most recent) * Clinical diagnosis of HF within 1 year, evidenced by any one: Hospital discharge with primary or secondary HF diagnosis, ER discharge with primary diagnosis of HF, ambulatory diagnostic code for HF and diuretic use, BNP\>35 ng/L or NTproBNP \>125 ng/L at any time * Expected ability to fully participate in study (can tolerate study processes, no long travel) Exclusion Criteria: * Unable to provide informed consent * Previous documented EF =\< 35% * Currently o…
Interventions
- OtherBeta blocker
Participants randomized to intervention will be dosed and titrated on beta blocker according to study protocol.
Location
- Henry Ford HealthDetroit, Michigan