Heart failure reviews

Treatments for heart failure with normal pumping function: searching for key approaches

Updated

Abstract

Nearly 8 million individuals in the USA are affected by heart failure, with half diagnosed with heart failure with preserved ejection fraction (HFpEF).

  • HFpEF is linked to high rates of morbidity and mortality, with fewer than 25% of patients surviving beyond 5 years after diagnosis.
  • Historically, the lack of effective disease-modifying therapies has contributed to poor outcomes in HFpEF.
  • Recent clinical trials have shown benefits from novel therapeutic classes, including sodium-glucose cotransporter 2 inhibitors, non-steroidal mineralocorticoid receptor antagonists, and glucagon-like peptide-1 receptor agonists.
  • New therapies appear particularly effective for patients with obesity-related HFpEF.
  • The management of HFpEF has evolved from traditional treatments with limited efficacy to emerging targeted therapies.

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Full Text

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Funding

Competing interests

Declarations. Competing interests: Drs Harrington, Bonaca and Canonico receive salary support from CPC, a non-profit academic research organization affiliated with the University of Colorado, that receives or has received research grant/consulting funding between August 2021 and present from: Abbott Laboratories, Agios Pharmaceuticals, Inc., Alexion Pharma, Alnylam Pharmaceuticals, Inc., Amgen Inc., Angionetics, Inc., Anthos Therapeutics, Array BioPharma, Inc., AstraZeneca and Affiliates, Atentiv LLC, Audentes Therapeutics, Inc., Bayer and Affiliates, Bristol-Meyers Squibb Company, Cambrian Biopharma, Inc., Cardiol Therapeutics Inc., CellResearch Corp., Cleerly Inc., Cook Regentec LLC, CSL Behring LLC, Eidos Therapeutics, Inc., EP Trading Co. Ltd., Epizon Pharma, Inc., Esperion Therapeutics, Inc., Everly Well, Inc., Exicon Consulting Pvt. Ltd., Faraday Pharmaceuticals, Inc., Foresee Pharmaceuticals Co. Ltd., Fortress Biotech, Inc., HDL Therapeutics Inc., HeartFlow Inc., Hummingbird Bioscience, Insmed Inc., Ionis Pharmaceuticals, Janssen and Affiliates, Kowa Research Institute, Inc., Lexicon Pharmaceuticals, Inc., Medimmune Ltd., Merck & Affiliates, Nectero Medical Inc., Novartis Pharmaceuticals Corp., Novo Nordisk, Inc., Osiris Therapeutics Inc., Pfizer Inc., PhaseBio Pharmaceuticals, Inc., Prairie Education and Research Cooperative, Prothena Biosciences Limited, Regeneron Pharmaceuticals, Inc., Regio Biosciences, Inc., Sanofi-Aventis Groupe, Silence Therapeutics PLC, Smith & Nephew plc, Stealth BioTherapeutics Inc., VarmX, Virta Health Corporation. Dr. Ambrosy has received relevant research support through grants to his institution from the National Heart, Lung, and Blood Institute (K23HL150159 and R01 AG091005), the American Heart Association (2nd Century Early Faculty Independence Award), The Permanente Medical Group, Northern California Community Benefits Programs, Garfield Memorial Fund, Abbott Laboratories, Amarin Pharma, Inc., Bayer, Cordio Medical, Edwards Lifesciences LLC, Esperion Therapeutics, Inc., Merck, and Novartis. Dr. Tavares reported receiving lecture fees from Novo Nordisk outside the submitted work. Dr. Vardeny has received research support through grants to her institution from AstraZeneca, Bayer, Cardurion, and consulting fees from AstraZeneca, Bayer, Cardior, Cytokinetics, Moderna, and Novo Nordisk. Drs Andrew P Ambrosy, Josephine L Harrington, and Mario Enrico Canonico are Editorial Board Members.
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