Phase II Study of the Effect of CK-1827452 Injection on Myocardial Efficiency

Inclusion Criteria:

- Clinical indication for left and right heart catheterization

- Willing and able to provide informed consent

- Male or female 18 years of age or greater

- Symptomatic heart failure (≥ NYHA Class II)

- Ejection fraction ≤ 35%

- Patient is in sinus rhythm

- Patient is considered to be in suitable health in the opinion of the investigator, as
determined by:

o A pre-study physical examination with no clinical abnormalities which in the
opinion of the investigator would preclude participation in the study other than
physical symptoms or signs consistent with stable heart failure

- For female patients only: Post-menopausal or sterilized, or if she is of childbearing
potential, she is not breastfeeding, her pregnancy test is negative, she has no
intention to become pregnant for up to 90 days following the study, and she is using
contraceptive drugs or devices

Exclusion Criteria:

- Acute myocarditis

- Hypertrophic, restrictive, or constrictive cardiomyopathy

- Congenital heart disease

- Known left ventricular thrombus

- Significant stenotic valvular disease (severe aortic stenosis, mitral stenosis)

- Poorly controlled hypertension (SBP > 180 mmHg)

- Pacemaker dependent ventricular rhythm

- Detectable troponin or CK-MB > ULN at any timepoint within 14 days of enrollment

- Acute coronary syndrome or revascularization procedure within 30 days of enrollment

- ≥ 50% stenosis of the left main coronary artery

- Plan for immediate revascularization procedure (PCI or CABG)

- GFR ≤ 35 ml/min/1.73 m2 by Modification of Diet in Renal Disease (MDRD) Equation or
need for renal replacement therapy

- Known hepatic impairment (total bilirubin > 3 mg/dL, or ALT and AST > 2 times the
upper limit of normal)

- Has received an investigational drug or device within 30 days before enrollment

- Has had any prior treatment with CK-1827452