Carillon Device for Heart Failure with Mitral Regurgitation

Recruiting at96 trial locations

Overseen by Samir Kapadia

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: Cardiac Dimensions, Inc.

Must be taking: Heart failure medications

Disqualifiers: Mitral valve pathology, Aortic stenosis, others

No Placebo Group

Approved in 3 Jurisdictions

Trial Summary

What is the purpose of this trial?

This trial is testing a device called the Carillon Mitral Contour System, which helps the mitral valve in the heart work better. It targets patients with heart failure and a specific valve problem. The device reshapes the valve to improve its function and reduce symptoms.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, it mentions that participants should be on a guideline-directed heart failure medication regimen, which suggests you may need to continue certain heart medications.

What data supports the effectiveness of the Carillon Mitral Contour System treatment for heart failure with mitral regurgitation?

The Carillon Mitral Contour System has been shown to reduce mitral regurgitation and heart chamber sizes in patients with heart failure, leading to improved quality of life and heart function. Studies have demonstrated its effectiveness in reducing symptoms and improving outcomes in patients with functional mitral regurgitation. ^{1 2 3 4 5}

Is the Carillon Device safe for humans?

The Carillon Device has been studied in several trials for heart conditions, and it has been found to reduce heart valve issues without major safety concerns. It is a minimally invasive procedure, and safety checks are performed during its placement to ensure it does not affect nearby blood vessels. ^{1 2 3 4 5}

How is the Carillon Mitral Contour System treatment different from other treatments for heart failure with mitral regurgitation?

The Carillon Mitral Contour System is unique because it is a minimally invasive treatment that uses a catheter to place a device in the coronary sinus, which helps reduce the size of the mitral valve opening and decrease mitral regurgitation. Unlike traditional surgical methods, this approach is less invasive and can be performed without open-heart surgery, offering a novel option for patients with heart failure and mitral regurgitation. ^{1 2 3 4 5}

Research Team

Samir Kapadia

Principal Investigator

The Cleveland Clinic

Randall Starling, MD

Principal Investigator

The Cleveland Clinic

Eligibility Criteria

This trial is for adults with heart failure and mild to severe functional mitral regurgitation who can walk a bit but not too far, have reduced heart pumping function, and are on standard heart failure meds. Not eligible if they need certain other heart treatments or have specific valve issues or devices already in place.

Inclusion Criteria

I have been diagnosed with a type of heart muscle disease.

I have mild to moderate heart valve leakage and surgery isn't needed within a year.

My heart condition limits my physical activity.

Exclusion Criteria

I do not have severe health issues, other than heart failure, that would limit my life to under a year.

I need or will need a special heart therapy within the next year.

I have a serious mitral valve condition as confirmed by a specialist.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (in-person)

Randomization and Baseline Assessment

Eligible subjects undergo baseline assessments including echocardiographic examination, coronary angiogram, and venogram before randomization

1-2 weeks

1 visit (in-person)

Treatment

Subjects in the Intervention group undergo the Carillon implant procedure, while Control group subjects undergo a similar index procedure without device placement

1 day

1 visit (in-person)

Follow-up

Subjects are evaluated at 1, 6, 12, 18, and 24 months post-randomization to assess long-term safety and functional status

24 months

5 visits (in-person)

Long-term Follow-up

After unblinding at 24 months, all subjects are followed with annual contact and echocardiogram for an additional three years

3 years

3 visits (in-person)

Treatment Details

Interventions

• Carillon Mitral Contour System (Device)

Trial Overview The EMPOWER Trial is testing the Carillon Mitral Contour System's safety and effectiveness against standard medications for treating heart failure caused by leaky mitral valves. Participants will be randomly assigned to receive either the device or continue with their usual medication.

Participant Groups

Group I: Intervention Group Experimental Treatment 2 Interventions

Carillon Mitral Contour System and Guideline Directed Heart Failure Medication

Group II: Control Group Active Control 1 Intervention

Guideline Directed Heart Failure Medication

Who Is Running the Clinical Trial?

Cardiac Dimensions, Inc.

Lead Sponsor

Trials

2

Recruited

550+

Findings from Research

The CARILLON® mitral contour system significantly reduces mitral regurgitation (MR) severity and left atrial (LA) volume in heart failure patients, as shown in a meta-analysis of 209 participants from three studies, with a notable decrease in MR volume and grade.

Patients treated with the CARILLON® device experienced improved functional status, reflected by a better New York Heart Association class and a lower rate of heart failure hospitalizations compared to controls, indicating its potential to enhance quality of life and reduce hospital visits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Individual patient data meta-analysis of the effects of the CARILLON® mitral contour system. Giallauria, F., Di Lorenzo, A., Parlato, A., et al.[2021]

The Carillon Mitral Contour System significantly improved quality of life and functional capacity in heart failure patients with functional mitral regurgitation, as evidenced by increased 6-minute walk test distances and Kansas City Cardiomyopathy Questionnaire scores at both 1 and 12 months post-implantation.

In a meta-analysis of 139 patients, over 60% reported meaningful improvements in quality of life, and nearly 68% experienced a reduction in heart failure severity (NYHA class) within the first month, indicating the device's efficacy in managing symptoms of heart failure.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Carillon Mitral Contour System on patient-reported outcomes in functional mitral regurgitation: an individual participant data meta-analysis. Khan, MS., Friede, T., Anker, SD., et al.[2021]

The modified Carillon® Mitral Contour System® was safely implanted in 36 patients with congestive heart failure and significant functional mitral regurgitation, with only one unrelated major adverse event occurring within 30 days.

Patients showed significant reductions in mitral regurgitation and improvements in functional capacity, such as better performance on 6-minute walk tests, indicating the device's efficacy in treating FMR without the previously observed issue of anchor fractures.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Coronary sinus-based percutaneous annuloplasty as treatment for functional mitral regurgitation: the TITAN II trial. Lipiecki, J., Siminiak, T., Sievert, H., et al.[2021]

The Carillon Mitral Contour System is a minimally invasive catheter-based procedure that effectively reduces functional mitral valve regurgitation by converging the valve leaflets using a nitinol clip implanted in the coronary sinus.

The procedure is performed under fluoroscopy and is verified for success through transesophageal echocardiography, ensuring that it does not impair coronary vessel perfusion, allowing for additional cardiac therapies like resynchronization therapy to be performed afterward.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Percutaneous mitral valve annuloplasty with the carillon mitral contour system by cardiac dimensions. A minimally invasive therapeutic option for the treatment of severe functional mitral valve regurgitation]. Degen, H., Lickfeld, T., Stoepel, C., et al.[2021]

The Carillon Mitral Contour System was evaluated in a real-world setting with 101 patients, showing significant reductions in mitral regurgitation and improvements in heart failure symptoms over 5 years, similar to results from controlled trials.

Despite a 40.1% all-cause mortality rate and a 53.9% incidence of heart failure hospitalizations, the therapy demonstrated a favorable safety profile and potential benefits for patients with functional mitral regurgitation, including those previously excluded from clinical trials.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The CINCH-FMR postmarket registry: Real-world long-term outcomes with percutaneous mitral valve repair with the Carillon Mitral Contour System®. Yildiz, M., Haude, M., Sievert, H., et al.[2023]

References

1. England pubmed.ncbi.nlm.nih.gov

Individual patient data meta-analysis of the effects of the CARILLON® mitral contour system. [2021]

2. England pubmed.ncbi.nlm.nih.gov

Effect of Carillon Mitral Contour System on patient-reported outcomes in functional mitral regurgitation: an individual participant data meta-analysis. [2021]

3. England pubmed.ncbi.nlm.nih.gov

Coronary sinus-based percutaneous annuloplasty as treatment for functional mitral regurgitation: the TITAN II trial. [2021]

4. Germany pubmed.ncbi.nlm.nih.gov

[Percutaneous mitral valve annuloplasty with the carillon mitral contour system by cardiac dimensions. A minimally invasive therapeutic option for the treatment of severe functional mitral valve regurgitation]. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

The CINCH-FMR postmarket registry: Real-world long-term outcomes with percutaneous mitral valve repair with the Carillon Mitral Contour System®. [2023]