Heart failure affects over 900,000 people in the UK, with around 200,000 new diagnoses each year. It remains one of the most significant causes of hospitalisation and premature death. Yet the treatment landscape is transforming rapidly — SGLT2 inhibitors, ARNI therapy, gene therapies, and regenerative approaches are reshaping what is possible. Here is what is actively recruiting in UK clinical trials right now.
The UK punches above its weight in cardiovascular research. With the NHS providing universal access to care and the NIHR Clinical Research Network supporting trial delivery, UK heart failure trials attract major international sponsorship.
Currently there are over 200 actively recruiting heart failure trials in the UK. Key areas of focus include: SGLT2 inhibitors in new patient populations, cardiac gene therapy, stem cell-derived cardiomyocyte patches, next-generation implantable devices, and digital heart failure management platforms.
The landmark DAPA-HF and EMPEROR-Reduced trials, both with significant UK recruitment, established SGLT2 inhibitors as foundational therapy. Current trials are now asking: can we go further?
HFrEF vs HFpEF — Why It Matters for Trials
Heart failure is classified by ejection fraction — the percentage of blood the left ventricle pumps with each beat:
HFrEF (Reduced EF ≤40%)
The heart muscle is weakened. Has the strongest evidence base — SGLT2 inhibitors, ARNI, beta blockers, MRAs, and ivabradine all have proven benefit. Most trials in this space now focus on additive therapies and novel mechanisms.
HFpEF (Preserved EF ≥50%)
The heart is stiff, not weak. Historically under-treated — until recently, no drug had definitively improved outcomes. SGLT2 inhibitors changed this, and HFpEF is now the fastest-growing area of heart failure research.
There is also HFmrEF (mid-range, 41–49%), which sits between the two and is increasingly recognised as a distinct entity requiring its own evidence base.
When searching for trials, knowing your ejection fraction is essential — most trials recruit either HFrEF or HFpEF patients exclusively.
Pharmacological Trials
Drug trials remain the backbone of heart failure research. Active areas include:
SGLT2 inhibitors in new populations — expanding beyond established HFrEF into HFpEF subtypes, post-MI heart failure, and cardio-renal syndrome
Next-generation ARNI — exploring sacubitril/valsartan combinations with novel agents and in earlier disease stages
Soluble guanylate cyclase (sGC) stimulators — vericiguat and next-generation compounds targeting the nitric oxide pathway
Anti-inflammatory therapies — targeting the inflammatory cascade that drives heart failure progression
Novel diuretics — better fluid management with fewer metabolic side effects
Device and Interventional Trials
Device therapy is evolving beyond traditional pacemakers and ICDs:
Cardiac contractility modulation (CCM) — delivering signals during the absolute refractory period to strengthen heart muscle without increasing heart rate
Left atrial appendage occlusion — in heart failure patients with atrial fibrillation
Interstitial lung fluid monitoring — implantable sensors that detect fluid accumulation before symptoms develop
Baroreceptor activation therapy — modulating the autonomic nervous system to improve heart failure outcomes
Mitral valve interventions — transcatheter edge-to-edge repair and percutaneous mitral valve replacement in heart failure with mitral regurgitation
Regenerative Medicine
Perhaps the most exciting frontier in heart failure research is regenerative therapy — treatments that aim to repair or replace damaged heart muscle:
Gene therapy — delivering genes encoding SERCA2a, S100A1, or adenylate cyclase to improve calcium handling and contractility
mRNA therapy — using mRNA technology (pioneered in COVID vaccines) to produce therapeutic proteins directly in the heart
Cardiac patches — bioengineered tissue patches seeded with stem cells that are surgically applied to damaged areas
Exosome therapy — using cell-derived vesicles to promote cardiac repair without the challenges of live cell delivery
Most regenerative trials are Phase 1/2, meaning they are early in development but represent potentially transformative approaches.
Heart Failure with Comorbidities
Many heart failure trials target specific comorbid conditions:
Heart failure with atrial fibrillation — a common and challenging combination, with trials studying rhythm control strategies and novel anticoagulation
Cardio-renal syndrome — the interplay between heart and kidney failure, with SGLT2 inhibitors and novel diuretics being studied
Heart failure with type 2 diabetes — overlapping treatment benefits, with GLP-1 agonists and SGLT2 inhibitors at the intersection
Heart failure with iron deficiency — intravenous iron therapy trials showing improvement in symptoms and quality of life
Post-MI heart failure — early intervention trials to prevent remodelling after myocardial infarction
Eligibility and Biomarkers
Heart failure trials typically require:
A confirmed diagnosis of heart failure (NYHA Class II–IV)
Documented ejection fraction (echo, cardiac MRI, or MUGA scan)
Elevated BNP or NT-proBNP levels — the key biomarker for trial eligibility
Stable on optimised guideline-directed medical therapy (GDMT) for at least 4 weeks
Recent echocardiogram (within 6 months)
eGFR and electrolyte monitoring (kidney function affects eligibility)
💡 Know Your Numbers
Before searching for heart failure trials, gather: your most recent ejection fraction (from echocardiogram or cardiac MRI), NT-proBNP or BNP result, current medications and doses, eGFR, and any recent hospitalisations for heart failure. These are the most common eligibility checkpoints.
UK Trial Centres
Major UK heart failure trial centres include:
London — Royal Brompton, Hammersmith, St Bartholomew's, King's College Hospital
Glasgow — Golden Jubilee National Hospital, Queen Elizabeth University Hospital
Manchester — Manchester Royal Infirmary, Wythenshawe Hospital
Birmingham — Queen Elizabeth Hospital Birmingham
Leeds — Leeds General Infirmary, Leeds Teaching Hospitals
Cambridge — Royal Papworth Hospital, Addenbrooke's
Newcastle — Freeman Hospital, Newcastle upon Tyne Hospitals
Our Smart Matcher can help you find heart failure trials tailored to your specific situation — your ejection fraction, current medications, NT-proBNP levels, and comorbidities. It takes about 3 minutes to complete and provides instant results.
Find Heart Failure Trials For You
Our Smart Matcher uses your heart failure type, ejection fraction, medications, and biomarkers to find the most relevant clinical trials.