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Cited by 436Cardiovascular Function and Risk FactorsHeart Failure Treatment and ManagementCardiac Fibrosis and Remodeling

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Research Priorities for Heart Failure With Preserved Ejection Fraction: National Heart, Lung, and Blood Institute Working Group Summary

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Shah, Sanjiv J., Borlaug, Barry A., Kitzman, Dalane W., McCulloch, Andrew D., Blaxall, Burns C., Agarwal, Rajiv, Chirinos, Julio A., Collins, Sheila, Deo, Rahul C., Gladwin, Mark T., Granzier, Henk, Hummel, Scott L., Kass, David A., Redfield, Margaret M., Sam, Flora, Wang, Thomas J., Desvigne-Nickens, Patrice, Adhikari, Bishow B.·2020·Circulation
DOI 10.1161/circulationaha.119.041886PMC PMC7101072
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Abstract

Heart failure with preserved ejection fraction (HFpEF), a major public health problem that is rising in prevalence, is associated with high morbidity and mortality and is considered to be the greatest unmet need in cardiovascular medicine today because of a general lack of effective treatments. To address this challenging syndrome, the National Heart, Lung, and Blood Institute convened a working group made up of experts in HFpEF and novel research methodologies to discuss research gaps and to prioritize research directions over the next decade. Here, we summarize the discussion of the working group, followed by key recommendations for future research priorities. There was uniform recognition that HFpEF is a highly integrated, multiorgan, systemic disorder requiring a multipronged investigative approach in both humans and animal models to improve understanding of mechanisms and treatment of HFpEF. It was recognized that advances in the understanding of basic mechanisms and the roles of inflammation, macrovascular and microvascular dysfunction, fibrosis, and tissue remodeling are needed and ideally would be obtained from (1) improved animal models, including large animal models, which incorporate the effects of aging and associated comorbid conditions; (2) repositories of deeply phenotyped physiological data and human tissue, made accessible to researchers to enhance collaboration and research advances; and (3) novel research methods that take advantage of computational advances and multiscale modeling for the analysis of complex, high-density data across multiple domains. The working group emphasized the need for interactions among basic, translational, clinical, and epidemiological scientists and across organ systems and cell types, leveraging different areas or research focus, and between research centers. A network of collaborative centers to accelerate basic, translational, and clinical research of pathobiological mechanisms and treatment strategies in HFpEF was discussed as an example of a strategy to advance research progress. This resource would facilitate comprehensive, deep phenotyping of a multicenter HFpEF patient cohort with standardized protocols and a robust biorepository. The research priorities outlined in this document are meant to stimulate scientific advances in HFpEF by providing a road map for future collaborative investigations among a diverse group of scientists across multiple domains.

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Authors
Shah, S. J., Borlaug, B. A., Kitzman, D. W., McCulloch, A. D., Blaxall, B. C., Agarwal, R., Chirinos, J. A., Collins, S., Deo, R. C., Gladwin, M. T., Granzier, H., Hummel, S. L., Kass, D. A., Redfield, M. M., Sam, F., Wang, T. J., Desvigne-Nickens, P., & Adhikari, B. B.
Affiliations
  • Northwestern University (US)
  • Mayo Clinic (US)
  • Wake Forest University Health Sciences (US)
  • University of California San Diego (US)
  • Christ Hospital (US)
  • Indiana University Indianapolis (US)
  • University of Pennsylvania (US)
  • Vanderbilt University (US)
  • Brigham and Women's Hospital (US)
  • University of Pittsburgh (US)
  • University of Arizona (US)
  • University of Michigan (US)
  • Johns Hopkins University (US)
  • Boston University (US)
  • National Institutes of Health (US)
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2020-03-24
Volume
141
Issue
12
Pages
1001-1026
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/circulationaha.119.041886
PMC
PMC7101072
OpenAlex
W3012616651
Cited by
436
References
114
Citations by year
2026: 53 · 2025: 74 · 2024: 74 · 2023: 67 · 2022: 99 · 2021: 49 · 2020: 19
FWCI
9.93
Type
journal article
Language
en
Open access
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute on Aging (R01AG018915, R01AG045551, R01AG058969, P30AG021332, U24AG059624)
  • National Heart, Lung, and Blood Institute (R01HL128526, R61HL146390, R01HL118524, U01HL125175, R01HL127028, R01HL144657, R01HL104106, R01HL126638, U10HL110262, R01HL149423, DP2HL123228, R35HL135827, P01HL103455, R01HL117153, R01HL140731, P01HL094307, R01HL132551, U01HL125205, R01HL133695, R01HL121510, R01HL107577, R56HL136730, R01HL134321, R01HL125886, R01HL098032, T32HL110849)
  • National Cancer Institute (K12CA090625)
  • National Institute of Diabetes and Digestive and Kidney Diseases (R01DK103056, P50DK096418)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
Keywords
heart failure with preserved ejection fraction, research priorities, research gaps, animal models, inflammation, microvascular dysfunction, macrovascular dysfunction, fibrosis, tissue remodeling, biorepository, multiscale modeling, translational research
MeSH terms
Heart Failure, Humans, Research, Stroke Volume, United States, National Heart, Lung, and Blood Institute (U.S.)

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