Safety and Efficacy of Doxycycline in Patients With Non-Ischemic Cardiomyopathy

In this study of Safety and Efficacy of Doxycycline in Patients with Non-Ischemic
Cardiomyopathy Population, we will enroll 24 patients with a clinical diagnosis of heart
failure and non-ischemic cardiomyopathy (recent imaging study documenting LV ejection
fraction <50%, and no history of coronary or ischemic heart disease) in a single-center,
randomized, double-blinded, placebo-controlled clinical trial with allocation 1:1:1 to
Doxycycline 100 mg twice daily or Doxycycline 20 mg twice daily or Placebo for 2 weeks.

Inclusion Criteria:

- Non-ischemic cardiomyopathy (LVEF<40%)

- Heart failure NYHA II-III

Exclusion Criteria:

- Age <18

- Recent changes (previous 3 months) in HF maintenance medications (beta-blockers,
angiotensin converting enzyme [ACE] inhibitors, aldosterone antagonists,
vasodilators, cardiac glycosides, diuretics)

- Hospitalization for worsening HF or acute decompensated HF within the previous 12
months

- History of coronary or ischemic heart disease

- Anticipated need for cardiac resynchronization therapy (CRT) or automated-implantable
cardioverter defibrillator (AICD) or coronary revascularization or cardiac surgery

- Angina or electrocardiograph (ECG) changes that limit maximum exertion during
cardiopulmonary exercise testing

- Active infection including chronic infection

- Active cancer (or prior diagnosis of cancer within the past 10 years)

- Recent (<14 days) use of anti-inflammatory drugs (not including NSAIDs), Chronic
inflammatory disorder (including but not limited to rheumatoid arthritis, systemic
lupus erythematosus), malignancy, or any comorbidity limiting survival or ability to
complete the study

- Pregnancy

- Inability to give informed consent

- Other conditions limiting completion of cardiopulmonary exercise test or completion
of the study