Elsevier

JACC: Heart Failure

Volume 2, Issue 2, April 2014, Pages 97-112
JACC: Heart Failure

Mini Focus Issue: Heart Failure With Preserved Ejection Fraction
State-of-the-Art Paper
Developing Therapies for Heart Failure With Preserved Ejection Fraction: Current State and Future Directions

https://doi.org/10.1016/j.jchf.2013.10.006Get rights and content
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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.

Key Words

epidemiology
heart failure
preserved ejection fraction
prognosis
treatment

Abbreviations and Acronyms

EF
ejection fraction
HF
heart failure
HFpEF
heart failure with preserved ejection fraction
HFrEF
heart failure with reduced ejection fraction
LV
left ventricular
LA
left atrial
NP
natriuretic peptide

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The opinions and information in this article are those of the authors, and do not represent the views and/or policies of the U.S. Food and Drug Administration. Dr. Fonarow has served as a consultant for Novartis, Medtronic, and Gambro, and has received research support from Gambro, the National Institutes of Health, and the Agency for Healthcare Research and Quality. Dr. Zile has received research support from NHLBI, VA, Alere, Bayer, CVRx, Medtronic, Novartis, Sanofi-Aventis; and has served as a consultant for Abbott, Alere, Bayer, BG Med, BMS, Cardiome, Celledon, CorAssist, CVRx, GE Health, HDL, Idenex, Intersection Medical, Medtronic, MicroVide, Novartis, ONO Pharma, Sanofi-Aventis, and Up-To-Date. Dr. Lam has served as a consultant for Bayer and Novartis and has received research grant support from Boston Scientific, Medtronic, and Vifor Pharma. Dr. Roessig is an employee of Bayer Pharma. Dr. Schelbert received a Prohance contrast as a gift from Bracco for research purposes. Dr. Cleland has received research funding from Amgen and honoraria from Novartis. Dr. Cody is an employee of Janssen R&D. Dr. Collins has served as a consultant for Novartis, Radiometer, Medtronic, The Medicines Company, Trevena, and Thermo-Fisher Scientific. Dr. Filippatos has served on the steering committee in trials sponsored by Bayer and Corthera. Dr. Lefkowitz is an employee of Novartis. Dr. McMurray was a committee member and co-principal investigator for the PARAGON-HF trial with LCZ696 in HF-PEF, which was sponsored by Novartis. Dr. Misselwitz is an employee of and owns stock for Bayer. Dr. Pfeffer has served as a consultant for Aastrom, Amgen, Bristol-Myers-Squibb, Cerenis, Concert, Genzyme, Hamilton Health Sciences, Keryx, Medtronic, Merck, Novartis, Roche, Servier, Teva, the University of Oxford, and Xoma. Dr. Pieske has received honoraria from Bayer, Servier, Medtronic, Menarini, Daiichi-Sankyo, and Boehringer Ingelheim. Dr. Pitt has served as a consultant for Pfizer, Bayer, Relypsa, Stealth Peptides, and Mesoblast. Dr. Solomon has received research support from and has served as a consultant for Novartis and Bayer. Dr. Teerlink has received research support and consulting fees from Novartis. Dr. Gheorghiade has served as a consultant for Novartis, Bayer, Takeda, and Janssen. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.