Colchicine in Patients With Heart Failure and Preserved Left Ventricular Ejection Fraction

Heart failure with preserved left ventricular ejection fraction (HFpEF) is a syndrome associated with high morbidity and mortality rates. Systemic low-grade inflammation is acknowledged to be a fundamental pathophysiological mechanism of HFpEF. Interventions targeting inflammatory pathway is understudied in HFpEF. Colchicine is a safe and well tolerated anti-inflammatory drug, which interferes with several steps in the inflammatory process. The drug has been extensively studied in different cardiovascular pathologies except HFpEF. We assume that colchicine decreases inflammation and reduces sST2 levels in HFpEF.

Inclusion Criteria:40 years of age, male and femaleLeft ventricular ejection fraction (LVEF) ≥ 50%Symptoms and signs of heart failureN-terminal pro-B-type natriuretic peptide (NT-proBNP) ≥300 pg/ml at baseline (patients in atrial fibrillation at baseline NT-proBNP ≥ 600 pg/ml), left atrial volume index (LAVI) >34 mL/m2 or a left ventricular mass index (LVMI) =115 g/m2 for males and =95 g/m2 for femalesbody mass index (BMI) > 30kg/m2 or diabetes mellitusExclusion Criteria:Hypertrophic cardiomyopathy, constrictive pericarditis, or cardiac amyloidosisAcute decompensation of HF in the last 1 monthValvular heart diseasePrior history of LVEF below 50%Acute myocardial infarction in the last 3 months, cardiac surgery or cerebrovascular accident within the recent 6 monthsAny active or chronic inflammatory diseases or infectionsPatients with indication for colchicine therapy or history of colchicine intoleranceSevere hepatic (alanine aminotransferase N3 upper limit of normal or renal dysfunction (estimated glomerular filtration rate <45 mL/min per 1.73m2)Severe nervous system diseasesHistory of any malignancy or suffering from cancerLack of informed consent