Clinical Trials

Inclusion Criteria:

• Resident of Southeastern Minnesota (Olmsted, Dodge, Fillmore, Mower, Freeborn, Wabasha, or Steele County).
• Current diagnosis of HF per NLP search.
• Age ≥ 60 years old.
• Clinically obtained cardiac imaging within 12 months of screening visit showing:
  • EF ≥ 40%; and
  • Cardiac imaging from any time point showing increased LV wall thickness as defined by an end-diastolic left ventricular septal or posterior wall thickness (LVWTd) ≥ 20% above the upper limit of normal measured by 2D or M-mode imaging in the parasternal long (2D) or short (M-mode) axis view (≥ 12 mm). 
• Objective evidence of HF defined as one or more of the following present within 24 months of screening visit:
  • Meets Framingham Criteria at screening visit (in-patient or outpatient);
  • Previous HF hospitalization ;
  • Invasive hemodynamic documentation of elevated PCWP or LVEDP (> 18 mmHg at rest or > 25 mmHg with exercise);
  • Left atrial enlargement + loop diuretic for HF;
  • Clinically obtained NT-proBNP > 300 (sinus rhythm) or > 900 (atrial fibrillation) pg/mL.

Exclusion Criteria:

• Documentation of previous EF < 40%.
• Any cardiac surgery or major chest trauma within 4 weeks of testing visit.
• Presence or history of hemodynamically significant left sided valvular disease defined as:
  • Greater than mild mitral stenosis;
  • Greater than moderate mitral regurgitation caused by intrinsic mitral valve disease (prolapse, flail).
• Myocardial infarction within 4 weeks of testing visit defined by typical angina, EKG changes and significant change in serial troponins.
  • Note that chronic troponin elevation is extremely common in cardiac amyloidosis. Hospitalized patients with troponin elevation but no significant change (delta) on serial testing will NOT be excluded.
• Prior or current exposure to Plaquenil (Hydroxychloroquine).