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JACC Heart Fail. 2014 Apr;2(2):97-112. doi: 10.1016/j.jchf.2013.10.006.

Developing therapies for heart failure with preserved ejection fraction: current state and future directions.

Author information

  • 1Department of Medicine, Emory Cardiovascular Clinical Research Institute, Emory University, Atlanta, Georgia. Electronic address: javed.butler@emory.edu.
  • 2Department of Medicine, University of California, Los Angeles, California.
  • 3Division of Cardiology, Medical University of South Carolina, and RHJ Department of Veterans Affairs Medical Center, Charleston, South Carolina.
  • 4Cardiovascular Research Institute, National University Health System, Singapore.
  • 5Global Clinical Development, Bayer HealthCare AG, Wuppertal, Germany.
  • 6Department of Medicine, University of Pittsburgh Medical Center Heart and Vascular Institute, Pittsburgh, Pennsylvania.
  • 7Department of Medicine, Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
  • 8Division of Gerontology, University of Alabama at Birmingham, Birmingham, Alabama.
  • 9Department of Cardiology, Castle Hill Hospital, Hull York Medical School, Kingston-Upon-Hull, England.
  • 10Cardiovascular & Metabolism Division, Janssen Pharmaceuticals, Raritan, New Jersey.
  • 11Institute of Emergency for Cardiovascular Diseases, Cardiology, Bucharest, Romania.
  • 12Department of Emergency Medicine, Vanderbilt University, Nashville, Tennessee.
  • 13Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland.
  • 14Department of Cardiology, Athens University Hospital, Attikon, Athens, Greece.
  • 15Novartis Pharmaceuticals Inc., East Hanover, New Jersey.
  • 16Department of Medicine, Emory Cardiovascular Clinical Research Institute, Emory University, Atlanta, Georgia.
  • 17British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, Scotland.
  • 18Division of Cardiology, University of Brescia, Brescia, Italy.
  • 19Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina.
  • 20Department of Medicine, Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts.
  • 21Department of Cardiology, Medical University Graz, Graz, Austria.
  • 22Division of Cardiology, Department of Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan.
  • 23Centre for Clinical and Basic Science, San Raffaele-Roma, Rome, Italy.
  • 24Department of Medicine, Henry Ford Hospital, Detroit, Michigan.
  • 25Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy.
  • 26University of California San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, California.

Abstract

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.

Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

epidemiology; heart failure; preserved ejection fraction; prognosis; treatment

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