Developing therapies for heart failure with preserved ejection fraction: current state and future directions.
The burden of heart failure with preserved ejection fraction (HFpEF) is considerable and is projected to worsen. To date, there are no approved therapies available for reducing mortality or hospitalizations for these patients. The pathophysiology of HFpEF is complex and includes alterations in cardiac structure and function, systemic and pulmonary vascular abnormalities, end-organ involvement, and comorbidities. There remain major gaps in our understanding of HFpEF pathophysiology. To facilitate a discussion of how to proceed effectively in future with development of therapies for HFpEF, a meeting was facilitated by the Food and Drug Administration and included representatives from academia, industry, and regulatory agencies. This document summarizes the proceedings from this meeting.
Department of Medicine, Emory Cardiovascular Clinical Research Institute, Emory University, Atlanta, Georgia. Electronic address: javed.butler@emory.edu.
Javed
J
Butler
Department of Medicine, University of California, Los Angeles, California.
Gregg C
GC
Fonarow
Division of Cardiology, Medical University of South Carolina, and RHJ Department of Veterans Affairs Medical Center, Charleston, South Carolina.
Michael R
MR
Zile
Cardiovascular Research Institute, National University Health System, Singapore.
Carolyn S
CS
Lam
Global Clinical Development, Bayer HealthCare AG, Wuppertal, Germany.
Lothar
L
Roessig
Department of Medicine, University of Pittsburgh Medical Center Heart and Vascular Institute, Pittsburgh, Pennsylvania.
Erik B
EB
Schelbert
Department of Medicine, Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Sanjiv J
SJ
Shah
Division of Gerontology, University of Alabama at Birmingham, Birmingham, Alabama.
Ali
A
Ahmed
Department of Medicine, Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Robert O
RO
Bonow
Department of Cardiology, Castle Hill Hospital, Hull York Medical School, Kingston-Upon-Hull, England.
John G F
JG
Cleland
Cardiovascular & Metabolism Division, Janssen Pharmaceuticals, Raritan, New Jersey.
Robert J
RJ
Cody
Institute of Emergency for Cardiovascular Diseases, Cardiology, Bucharest, Romania.
Ovidiu
O
Chioncel
Department of Emergency Medicine, Vanderbilt University, Nashville, Tennessee.
Sean P
SP
Collins
Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland.
Preston
P
Dunnmon
Department of Cardiology, Athens University Hospital, Attikon, Athens, Greece.
Gerasimos
G
Filippatos
Novartis Pharmaceuticals Inc., East Hanover, New Jersey.
Martin P
MP
Lefkowitz
Department of Medicine, Emory Cardiovascular Clinical Research Institute, Emory University, Atlanta, Georgia.
Catherine N
CN
Marti
British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, Scotland.
John J
JJ
McMurray
Global Clinical Development, Bayer HealthCare AG, Wuppertal, Germany.
Frank
F
Misselwitz
Division of Cardiology, University of Brescia, Brescia, Italy.
Savina
S
Nodari
Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina.
Christopher
C
O'Connor
Department of Medicine, Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts.
Marc A
MA
Pfeffer
Department of Cardiology, Medical University Graz, Graz, Austria.
Burkert
B
Pieske
Division of Cardiology, Department of Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan.
Bertram
B
Pitt
Centre for Clinical and Basic Science, San Raffaele-Roma, Rome, Italy.
Giuseppe
G
Rosano
Department of Medicine, Henry Ford Hospital, Detroit, Michigan.
Hani N
HN
Sabbah
Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy.
Michele
M
Senni
Department of Medicine, Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts.
Scott D
SD
Solomon
Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland.
Norman
N
Stockbridge
University of California San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, California.
John R
JR
Teerlink
Department of Medicine, Emory Cardiovascular Clinical Research Institute, Emory University, Atlanta, Georgia.
Vasiliki V
VV
Georgiopoulou
Department of Medicine, Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Mihai
M
Gheorghiade
D000818:Animals; D002986:Clinical Trials as Topic; D003971:Diastole / Q000502:physiology; D004195:Disease Models, Animal; D004452:Echocardiography; D005544:Forecasting; D006325:Heart Atria / Q000503:physiopathology; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology; D013318:Stroke Volume / Q000502:physiology*; D013599:Systole / Q000502:physiology; D016896:Treatment Outcome; D059289:Vascular Stiffness / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*
epidemiology; heart failure; preserved ejection fraction; prognosis; treatment