How to Develop and Implement a Specialized Heart Failure with Preserved Ejection Fraction Clinical Program

Sanjiv J. Shah, Rebecca Cogswell, John J. Ryan, Kavita Sharma

Research output: Contribution to journalReview articlepeer-review

22 Scopus citations


Heart failure with preserved ejection fraction (HFpEF), a highly prevalent and complex clinical syndrome with high morbidity and mortality, is often unrecognized and not optimally treated. Clinical trials for HFpEF have been plagued by low enrollment, and clinicians often approach HFpEF patients with “therapeutic nihilism” given the perceived lack of available therapies based on the disappointing results of these prior trials. Due to these challenges, we have pioneered the successful creation of dedicated, specialized HFpEF clinical programs. Here, we discuss (1) the rationale for the development of a specialized HFpEF clinical program; (2) strategies for the systematic identification of HFpEF patients; (3) a standardized diagnostic and therapeutic approach; (4) validation of the HFpEF clinical program paradigm; (5) staffing and reimbursement considerations; (6) HFpEF clinical trial enrollment; and (7) challenges and future directions for HFpEF clinical programs. We conclude that it is feasible to create HFpEF clinical programs that fulfill the major unmet need of identifying and caring for patients with HFpEF. These clinics are essential for confirming the HFpEF diagnosis, providing standardized treatment, and facilitating clinical trial enrollment. It is our hope that the information provided here will encourage others to establish their own specialized HFpEF programs, thereby allowing for comprehensive care for these complex patients.

Original languageEnglish (US)
Article number122
JournalCurrent Cardiology Reports
Issue number12
StatePublished - Dec 1 2016

Bibliographical note

Publisher Copyright:
© 2016, Springer Science+Business Media New York.

Copyright 2017 Elsevier B.V., All rights reserved.


  • Clinical trials
  • Diagnosis
  • Disease management program
  • Heart failure with preserved ejection fraction
  • Treatment


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