Beta-blocker and Early Add-on Therapy with Ivabradine in Acute Heart Failure with Reduced Ejection Fraction (BEAT-HFrEF)

Status

Active, not recruiting

Phases

Phase 4

Study type

Interventional

Source

CRIS

Registry ID

KCT0012126

Enrollment

250

Registered

2026-06-15

Start date

2026-06-15

Completion date

Unknown

Last updated

2026-06-22

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Interventions

Drug : This study compares two pharmacological treatment strategies in stabilized patients hospitalized for acute decompensated heart failure with reduced ejection fraction (HFrEF). Participants in t

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: Inclusion Criteria Adults aged 19 years or older who are capable of providing written informed consent. Patients hospitalized for acute decompensated heart failure with reduced ejection fraction (HFrEF), including both de novo and chronic heart failure. Left ventricular ejection fraction (LVEF = 40%) documented by echocardiography during the index hospitalization. Sinus rhythm with a resting heart rate of = 75 beats per minute (bpm). No use of beta-blockers within the previous 3 days prior to enrollment. Hemodynamically stable patients meeting all of the following criteria: Systolic blood pressure (SBP = 100 mmHg); No escalation of intravenous diuretics or administration of intravenous vasodilators within the previous 6 hours; No administration of intravenous inotropic agents within the previous 24 hours.

Exclusion criteria

Exclusion criteria: History of atrial fibrillation or atrial flutter. Acute coronary syndrome, stroke, cardiovascular intervention, or cardiovascular surgery within the previous 1 month. Contraindication to beta-blockers or ivabradine. Severe bradycardia (heart rate 180 mmHg. Planned cardiovascular surgery or intervention within the next 3 months. Hypertrophic cardiomyopathy or restrictive cardiomyopathy. Severe valvular heart disease requiring surgical or interventional correction. End-stage renal disease, defined as an estimated glomerular filtration rate (eGFR < 15 mL/min/1.73 m²).

Design outcomes

Primary

Measure	Time frame
Achievement rate of the target heart rate (50–60 bpm) on 24-hour ambulatory ECG monitoring (%)	—

Secondary

Measure	Time frame
Achievement of target HR(50-60 bpm);Composite efficacy and safety endpoint defined as achievement of target heart rate without discontinuation of beta-blocker therapy due to adverse events.;achieving =50% of target guideline-directed medical therapy (GDMT:beta-blocker, ARNI, SGLT2i, MRA ) doses;24-hour ambulatory ECG events, including: 1) Proportion of time with heart rate 70 bpm (%) 3) Occurrence of atrial fibrillation or atrial flutter during ambulatory ECG monitoring.;24-hour ambulatory blood pressure events, including: 1) Proportion of time with systolic blood pressure <90 mmHg (%); 2) Proportion of time with systolic blood pressure =140 mmHg (%).;Composite clinical outcome, including: 1) Reduction in NT-proBNP of =30% from baseline; 2) Improvement in left ventricular ejection fraction (LVEF) of =10% from baseline; 3) Heart failure-related urgent visits requiring intravenous diuretic therapy (outpatient clinic or emergency department); 4) Heart failure rehospitalization; 5) Cardiovascular death; 6) All-cause mortality.	—

Measure

Time frame

Achievement of target HR(50-60 bpm);Composite efficacy and safety endpoint defined as achievement of target heart rate without discontinuation of beta-blocker therapy due to adverse events.;achieving =50% of target guideline-directed medical therapy (GDMT:beta-blocker, ARNI, SGLT2i, MRA ) doses;24-hour ambulatory ECG events, including: 1) Proportion of time with heart rate 70 bpm (%) 3) Occurrence of atrial fibrillation or atrial flutter during ambulatory ECG monitoring.;24-hour ambulatory blood pressure events, including: 1) Proportion of time with systolic blood pressure <90 mmHg (%); 2) Proportion of time with systolic blood pressure =140 mmHg (%).;Composite clinical outcome, including: 1) Reduction in NT-proBNP of =30% from baseline; 2) Improvement in left ventricular ejection fraction (LVEF) of =10% from baseline; 3) Heart failure-related urgent visits requiring intravenous diuretic therapy (outpatient clinic or emergency department); 4) Heart failure rehospitalization; 5) Cardiovascular death; 6) All-cause mortality.

—

Countries

Korea, Republic of

Contacts

Public ContactHokon Kim

Yonsei University, Wonju Severance Christian Hospital

ulea82@hanmail.net+82-33-741-0910

Outcome results