Safety and Hemodynamic Effects and Pharmacokinetics of CXL-1020 in Patients With Stable Heart Failure

Inclusion Criteria:

In order to be eligible for randomization, a patient MUST:

Be a male or post menopausal or surgically sterile female outpatient between 18 and 85 years of age
Have chronic Systolic HF due to primary/idiopathic dilated cardiomyopathy, coronary artery disease or hypertension, and stable for at least 30 days prior to screening
Have a core echo lab confirmed left ventricular ejection fraction ≤ 40% in a baseline 2D-Echocardiogram prior to and within 60 days of the first dose of study medication with evidence of at least minimal LV dilation on the basis of an observed LV-EDV index that is above normal
Have a baseline NT-Pro-BNP of greater than or equal to the top of the normal reference range (124pg/ml) prior to and within 60 days of the first dose of study medication
Be on unchanging doses of HF medications (with exception of diuretic dosage) for 2 weeks prior to randomization without planned initiation of new hemodynamically active therapy during the conduct of the study
Be capable of understanding the nature of the trial and be willing to participate as documented by written informed consent
Be willing and able to comply with the study protocol requirements for the duration of the study, including pharmacokinetic sampling
If a post-menopausal or surgically sterile female, confirmation of sterility status (Post menopausal or surgically sterile for at least 6 months) - (Post-menopausal subjects will require a urine pregnancy test for confirmation prior to enrollment and urine pregnancy tests prior to each dosing)
If a fertile male, must be using 2 approved contraceptive methods (a condom and a spermicidal agent, even if the partner is using birth control) for the duration of the study and for 3 months following participation in the study and further agree to not donate sperm for 3 months after participation in the study. Must have a negative urine test for drugs of abuse and a negative ethanol breath test at screening and before each dosing period
Have required local lab data within non-exclusionary ranges before each dosing

Exclusion Criteria:

In order to be eligible for randomization, a patient MUST NOT:

Have participated in any investigational drug study within 30 days preceding randomization or have previously received therapy with CXL-1020
Have a heart rate <50 or ≥ 90 BPM at baseline prior to randomization.
Have a blood pressure >150 Systolic and/or >90 diastolic mmHg at baseline prior to randomization
Have a systolic blood pressure of less than 100 mmHg at baseline prior to randomization
Have QT/QTc prolongation > 460 msec or > 500msec in patients with preexisting bundle branch block (only applies to non-paced patients in sinus rhythm)
Have experienced a documented symptomatic or electrocardiographically recorded episode of atrial fibrillation/flutter within 60 days before screening and be in normal sinus rhythm at each baseline before study drug is administered
Have a history of sustained or hemodynamically significant VT or VF requiring cardioversion, or self-terminating VT associated with hypotension
Have non-sustained VT (HR > 120 bpm) of 10 beats or more during monitoring in the baseline monitoring period prior to each dose of study medication, or in any Holter or EKG recording within 1 year of first dose of study medication.
Have a weight or height that exceeds the specifications for the ICG Device of (greater than 341 pounds or taller than 7 feet 2 inches.)
Be post-successful cardiac resuscitation

Have a history of worsening HF within 30 days prior to screening as defined by:

Unscheduled ER or clinic visits relating to HF or hospital admission for management of HF
Treatment with intravenous inotropic or vasodilator drugs
Be diagnosed with acute coronary syndrome or acute myocardial infarction within three months prior to screening
Have a history of stroke (CVA) or transient ischemic attack (TIA) within six months prior to screening
Have a history of CCS Class III or IV angina
Be a patient whose HF etiology is attributable to either restrictive/obstructive cardiomyopathy, idiopathic hypertrophic cardiomyopathy (as defined by any wall thickness > 1.8 cm) or uncorrected severe valvular disease
Be receiving concomitant therapy with any antiarrhythmic drugs other than amiodarone
Have experienced the firing of an implantable ICD for documented ventricular ectopy within three months prior to screening
Have a known allergy to the ICG Device sensor gel or adhesive
Have unsuitable Echocardiographic Windows for the comprehensive Echo assessments required in the Echo cohorts (exclusion for echo cohorts only)
Have a skin lesion at the site of the ICG Device sensor placement.
Have a screening or baseline serum Na < 130 mEq/l or > 145 mEq/l; a serum K < 3.5 mEq/l or > 5.0 mEq/l; a serum Ca < 7.5 mg/dl or > 10 mg/dl; or a serum Mg < 1.6 mEq/l or > 3.0 mEq/l., or a digoxin level above 1ng/ml
Have a screening TSH < 0.1 mcU/ml or > 5.0 mcU/ml
Have a screening or baseline serum creatinine > 2.5 mg/dl; an ALT or AST >3 times the upper normal limit; or a hemoglobin < 10 g/dl
Have taken ethanol within 24 hours or a PDE5 inhibitor within 96 hours of study admission
Have other clinically significant laboratory or medical conditions that, in the opinion of the Investigator, make the patient unsuitable for evaluation in the study
Have a generalized atopic state or a history of a mild to moderate documented drug allergy
Be receiving a drug which is expected to possess the potential for a clinically significant pharmacokinetic interaction with CXL-1020, as defined in the IDB.

Note: Patients receiving cardiac resynchronization therapy for HF are eligible provided that the device has been placed for greater than 30 days and pacemaker settings can be left unchanged for the study period.