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Heart FailureU-SCREEN-HFNCT06940544

Uppsala Self-SCREENing of Heart Failure Study

A study testing Stepwise Multimodal Home-Based HF Screening in people with Heart Failure, run by Uppsala University at 1 site in Sweden.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is to investigate whether a stepwise multimodal home-based screening strategy with rapid point-of-care testing can detect undiagnosed heart failure (HF) in high-risk patients compared to usual care. Read more about this study

Who is it for?
Ages 40 years and olderHealthy volunteers can take part
Conditions the study is for
Heart Failure
What is being tested?
Stepwise Multimodal Home-Based HF Screening
Could I receive a placebo?
No, everyone receives an active treatment
How many people
500 participants
Where
1 siteSweden
Study dates
1 Feb 2023to 1 Aug 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 40 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Age ≥40 years, and at least one of the following symptoms of HF, and at least two risk factors for HF:
  • Symptoms
  • Dyspnoea on exertion
  • Dyspnoea at rest
  • Orthopnoea
  • Paroxysmal nocturnal dyspnoea
Show all 18Show fewer
  • Reduced exercise tolerance, increased time to recover after exercise
  • Fatigue, tiredness
  • Ankle swelling
  • Risk factors
  • Diabetes (type 1 or type 2)
  • Coronary artery disease (myocardial infarction or coronary artery bypass grafting or percutaneous coronary intervention)
  • Persistent or permanent atrial fibrillation (not paroxysmal atrial fibrillation)
  • Previous ischemic or embolic stroke
  • Peripheral arterial disease (previous surgical or percutaneous revascularisation)
  • Chronic kidney disease
  • Regular loop diuretic use (any dose at any dosing interval) for >30 days
  • COPD (diagnosis by respiratory physician, radiological emphysema or treatment with advocated COPD therapy)

Who cannot join

  • Previous diagnosis of HF
  • Previous renal replacement therapy
  • Inability to comply with study procedures or provide informed consent

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Sweden1 site, 1 recruiting
  • Uppsala Akademiska Hospital

    Uppsala

    Johan Sundström, MD, PhD, 0046186110000, johan.sundstrom@uu.se

    Recruiting

Other trials in Sweden

About this study

The goal of this clinical trial is to investigate whether a stepwise multimodal home-based screening strategy with rapid point-of-care testing can detect undiagnosed heart failure (HF) in high-risk patients compared to usual care. The study also aims to understand the impact of earlier HF diagnosis on treatment initiation, clinical outcomes, symptoms, functional capacity, health-related quality of life, healthcare utilization, and costs.

The main questions it aims to answer are:

Read more

Does a home-based screening strategy increase the diagnosis of HF within 6 months compared to usual care?

Does earlier diagnosis lead to more patients receiving guideline-directed medical therapy (GDMT) for HF with reduced ejection fraction (HFrEF) within 6 months?

What is the impact of this screening strategy on HF hospitalizations, mortality, functional capacity, health-related quality of life, and healthcare costs over 1, 2, and 5 years?

Researchers will compare a stepwise multimodal home-based screening strategy to usual care to determine if the screening strategy leads to earlier HF diagnosis and improved patient outcomes.

Participants will:

Provide dried blood spot samples for NTproBNP analysis by mail.

If NTproBNP is elevated (≥125 pg/ml), undergo point-of-care NTproBNP testing and an AI-enabled echocardiogram.

Be followed for up to 5 years through healthcare databases and self-reported symptom monitoring to track HF diagnosis, treatment initiation, clinical outcomes, and healthcare utilization.

The study will randomize 500 high-risk participants in a 1:1 ratio to either the ACTIVE arm (home-based screening) or the CONTROL arm (usual care). Participants with known HF are excluded.

The primary outcome is the diagnosis of HF within 6 months. Secondary outcomes include the diagnosis of HFrEF and initiation of GDMT within 6 months. Exploratory outcomes will assess long-term clinical outcomes (HF hospitalizations and death), functional capacity, quality of life, and cost-effectiveness at 1, 2, and 5 years.

This investigator-initiated trial is part of the international SYMPHONY study and is coordinated from Uppsala University and Uppsala University Hospital, Sweden. The study will use healthcare databases, registries, and digital resources for comprehensive outcome capture. The first patient visit is scheduled for February 1, 2023, with follow-up extending to August 2026 for the primary outcome and up to 5 years for exploratory outcomes.

Conditions
Heart Failure
Being tested
Stepwise Multimodal Home-Based HF Screening
Keywords
Heart Failure, Home-based screening, Point-of-care testing
Medical subject headings
Heart Failure

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Stepwise Multimodal Home-Based HF ScreeningDiagnostic test

    The Stepwise Multimodal Home-Based HF Screening intervention involves a targeted community outreach program to identify undiagnosed heart failure (HF) in high-risk individuals. Participants randomized to the intervention arm (ACTIVE) are asked to self-collect dried blood spots for NTproBNP analysis. Those with elevated NTproBNP (≥125 pg/ml) in the dried blood spots are summoned to the study clinic and undergo confirmatory point-of-care NTproBNP testing and an AI-enabled echocardiogram, with the aim to confirm or rule out heart failure.

Study groups in NCT06940544
Study groupRoleWhat they receive
SCREENING ArmExperimentalHome-Based HF Screening with NTproBNP and AI-Assisted Echocardiography
Receives: Diagnostic Test: Stepwise Multimodal Home-Based HF Screening
CONTROL ArmNo interventionUsual Care Without Systematic HF Screening

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Detection of undiagnosed heart failure (HF) in high-risk patients.

    Diagnosis of HF; HF is defined as either:

    1. an outpatient diagnosis of heart failure according to the ESC 2021 Heart Failure Guidelines,
    2. outpatient heart failure visit,
    3. an urgent heart failure visit, or
    4. a heart failure hospitalisation.

    Measured: Within 6 months.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Apr 2025
  2. Study start1 Feb 2023
  3. Primary completion1 Aug 2026 (estimated)
  4. Study completion1 Aug 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Screening
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
500 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06940544
Sponsor's protocol ID
2022-06248-01
Acronym
U-SCREEN-HF
Status last verified
Apr 2025
First submitted
17 Mar 2025
Last updated
23 Apr 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: Sharing of certain IPD may be prohibited for ethical reasons.

Publications

  • McGrady M, Krum H, Carrington MJ, Stewart S, Zeitz C, Lee GA, Marwick TH, Haluska BA, Brown A. Heart failure, ventricular dysfunction and risk factor prevalence in Australian Aboriginal peoples: the Heart of the Heart Study. Heart. 2012 Nov;98(21):1562-7. doi: 10.1136/heartjnl-2012-302229. Epub 2012 Aug 11.

    PubMed 22888160
  • Packer M. Do most patients with obesity or type 2 diabetes, and atrial fibrillation, also have undiagnosed heart failure? A critical conceptual framework for understanding mechanisms and improving diagnosis and treatment. Eur J Heart Fail. 2020 Feb;22(2):214-227. doi: 10.1002/ejhf.1646. Epub 2019 Dec 17.

    PubMed 31849132
  • Tromp J, Seekings PJ, Hung CL, Iversen MB, Frost MJ, Ouwerkerk W, Jiang Z, Eisenhaber F, Goh RSM, Zhao H, Huang W, Ling LH, Sim D, Cozzone P, Richards AM, Lee HK, Solomon SD, Lam CSP, Ezekowitz JA. Automated interpretation of systolic and diastolic function on the echocardiogram: a multicohort study. Lancet Digit Health. 2022 Jan;4(1):e46-e54. doi: 10.1016/S2589-7500(21)00235-1. Epub 2021 Dec 1.

    PubMed 34863649
  • Jorgensen B, Bertsch T, Broker HJ, Schafer M, Chapelle JP, Gadisseur R, Cowie MR, Dikkeschei B, Gurr E, Hayen W, Hafner G, Stiegler Y, Schonherr HR, Strasser RH, Weidtmann B, Folkerts H, Zugck C, Hofmann K, Zerback R. Multicentre evaluation of a second generation point-of-care assay with an extended range for the determination of N-terminal pro-brain natriuretic peptide. Clin Lab. 2012;58(5-6):515-25.

    PubMed 22783583
  • McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Bohm M, Burri H, Butler J, Celutkiene J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A; ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021 Sep 21;42(36):3599-3726. doi: 10.1093/eurheartj/ehab368. No abstract available.

    PubMed 34447992
  • Sundstrom J, Lind L, Nowrouzi S, Lytsy P, Marttala K, Ekman I, Ohagen P, Ostlund O. The Precision HYpertenSIon Care (PHYSIC) study: a double-blind, randomized, repeated cross-over study. Ups J Med Sci. 2019 Jan;124(1):51-58. doi: 10.1080/03009734.2018.1498958. Epub 2018 Sep 28.

    PubMed 30265168
  • Goldman L, Hashimoto B, Cook EF, Loscalzo A. Comparative reproducibility and validity of systems for assessing cardiovascular functional class: advantages of a new specific activity scale. Circulation. 1981 Dec;64(6):1227-34. doi: 10.1161/01.cir.64.6.1227.

    PubMed 7296795
  • Homar V, Mirosevic S, Svab I, Lainscak M. Natriuretic peptides for heart failure screening in nursing homes: a systematic review. Heart Fail Rev. 2021 Sep;26(5):1131-1140. doi: 10.1007/s10741-020-09944-w.

    PubMed 32200491
  • Ontario Health (Quality). Use of B-Type Natriuretic Peptide (BNP) and N-Terminal proBNP (NT-proBNP) as Diagnostic Tests in Adults With Suspected Heart Failure: A Health Technology Assessment. Ont Health Technol Assess Ser. 2021 May 6;21(2):1-125. eCollection 2021.

    PubMed 34055110
  • Mant J, Doust J, Roalfe A, Barton P, Cowie MR, Glasziou P, Mant D, McManus RJ, Holder R, Deeks J, Fletcher K, Qume M, Sohanpal S, Sanders S, Hobbs FD. Systematic review and individual patient data meta-analysis of diagnosis of heart failure, with modelling of implications of different diagnostic strategies in primary care. Health Technol Assess. 2009 Jul;13(32):1-207, iii. doi: 10.3310/hta13320.

    PubMed 19586584
  • Thorstensen A, Dalen H, Amundsen BH, Aase SA, Stoylen A. Reproducibility in echocardiographic assessment of the left ventricular global and regional function, the HUNT study. Eur J Echocardiogr. 2010 Mar;11(2):149-56. doi: 10.1093/ejechocard/jep188. Epub 2009 Dec 3.

    PubMed 19959533
  • Nagueh SF, Abraham TP, Aurigemma GP, Bax JJ, Beladan C, Browning A, Chamsi-Pasha MA, Delgado V, Derumeaux G, Dolci G, Donal E, Edvardsen T, El Tallawi KC, Ernande L, Esposito R, Flachskampf FA, Galderisi M, Gentry J, Goldstein SA, Harb SC, Hubert A, Hung J, Klein AL, Lancellotti P, Mahmood RZ, Marino P, Popescu BA, Previato M, Sanghai SR, Smiseth OA, Xu J; for Diastolic Function Assessment Collaborators. Interobserver Variability in Applying American Society of Echocardiography/European Association of Cardiovascular Imaging 2016 Guidelines for Estimation of Left Ventricular Filling Pressure. Circ Cardiovasc Imaging. 2019 Dec;12(1):e008122. doi: 10.1161/CIRCIMAGING.118.008122.

    PubMed 30632389
  • Ezekowitz JA, Kaul P, Bakal JA, Quan H, McAlister FA. Trends in heart failure care: has the incident diagnosis of heart failure shifted from the hospital to the emergency department and outpatient clinics? Eur J Heart Fail. 2011 Feb;13(2):142-7. doi: 10.1093/eurjhf/hfq185. Epub 2010 Oct 19.

    PubMed 20959343
  • Conrad N, Judge A, Canoy D, Tran J, O'Donnell J, Nazarzadeh M, Salimi-Khorshidi G, Hobbs FDR, Cleland JG, McMurray JJV, Rahimi K. Diagnostic tests, drug prescriptions, and follow-up patterns after incident heart failure: A cohort study of 93,000 UK patients. PLoS Med. 2019 May 21;16(5):e1002805. doi: 10.1371/journal.pmed.1002805. eCollection 2019 May.

    PubMed 31112552
  • Koudstaal S, Pujades-Rodriguez M, Denaxas S, Gho JMIH, Shah AD, Yu N, Patel RS, Gale CP, Hoes AW, Cleland JG, Asselbergs FW, Hemingway H. Prognostic burden of heart failure recorded in primary care, acute hospital admissions, or both: a population-based linked electronic health record cohort study in 2.1 million people. Eur J Heart Fail. 2017 Sep;19(9):1119-1127. doi: 10.1002/ejhf.709. Epub 2016 Dec 23.

    PubMed 28008698

Questions about this trial

What is this clinical trial studying?

A study testing Stepwise Multimodal Home-Based HF Screening in people with Heart Failure, run by Uppsala University at 1 site in Sweden.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 18 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 23 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Each site lists its own contact: choose the nearest one under Trial locations. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Detection of undiagnosed heart failure (HF) in high-risk patients. (time frame: Within 6 months.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06940544, which also lists 21 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Apr 2025.

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