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Northwestern receives $18.1M to study the most common type of heart failure

Diastolic heart failure affects 2.5M Americans; little is known about its causes, how to treat it

Northwestern University Feinberg School of Medicine has been awarded two grants totaling $18.1 million to study the most common type of heart failure: heart failure with preserved ejection fraction (HFpEF), also referred to as diastolic heart failure. 

HFpEF affects at least 2.5 million people in the U.S.; however the cardiovascular community has a very limited understanding of how to prevent or effectively treat it. 

The grants are funded by the National Institutes of Health (NIH), which has recently created the HeartShare program to develop a new cohort of patients with the disease to better understand it. Northwestern Medicine cardiologist Dr. Sanjiv Shah, director of Northwestern’s Bluhm Cardiovascular Institute-Clinical Trials Unit, director for the Center for Deep Phenotyping and Precision Therapeutics in the Institute of Augmented Intelligence in Medicine, and a professor of cardiology at Feinberg, will receive $16.7 million to lead the HeartShare Data Translation Center, which will coordinate the data for all six sites in the program. 

“In 2007, we developed the first dedicated HFpEF clinical program in the world here at Northwestern, and since that time have been a leading center for research, clinical trial enrollment and clinical care of HFpEF patients,” Shah said. “The HeartShare grant from the NIH is a phenomenal opportunity to continue our research to improve the classification of the heterogeneous HFpEF syndrome, understand the biological basis of HFpEF phenotypes and set the stage for precision medicine clinical trials for HFpEF.”  

Dr. Sadiya Khan, an assistant professor of cardiology and epidemiology at Feinberg and a Northwestern Medicine physician, will receive $1.4 million over the next five years to lead one of six clinical centers in the HeartShare program. 

“I am incredibly honored to have the opportunity to contribute to this one-of-a-kind program through the NIH HeartShare program,” Khan said. “This program offers new hope and excitement to transform care for patients with heart failure with preserved ejection. Before we can change the dismal trajectory for these patients, we need to understand why they get this type of heart failure. 

“This national initiative will be an enormous endeavor but is the kind of investment that is needed to answer one of the greatest unmet needs in cardiovascular medicine today,” Khan said. “Patients with HFpEF have been left behind with few options for therapy today. As a field, we have seen remarkable advances in the care of patients with heart failure with reduced ejection fraction (HFrEF, also called systolic failure), and we need to see the same type of progress for patients with HFpEF. 

In heart failure with preserved ejection fraction, the squeezing function of the patient’s heart is normal (hence the “preserved ejection fraction”), but the left ventricle loses its ability to relax normally because the muscle has become stiff. The heart can't properly fill with blood during the resting period between each beat, which can lead to symptoms of fluid buildup, shortness of breath and fluid retention. HFpEF also affects multiple other organs, including the lungs, kidneys, skeletal muscle and vasculature.

Laura Rasmussen-Torvik, chief of epidemiology in the department of preventive medicine at Feinberg, will serve as the multiple principal investigator for the clinical center. 

“As an epidemiologist, I am tremendously excited to be involved in this project, which will combine traditional observational study methods with innovative data science approaches to efficiently provide urgently needed information about biological pathways contributing to heart failure with preserved ejection fraction,” said Rasmussen-Torvik.

“While there are currently several treatments for systolic heart failure, there are very few for HFpEF, mainly because of the lack of understanding of how this condition develops and progresses,” Khan said.

“There are recent successes in new medical treatments, but addressing this condition known as ‘HFpEF’ remains an unmet need,” said Dr. Clyde Yancy, chief of cardiology at Feinberg and a Northwestern Medicine cardiologist. “The best direction in care inevitably requires new discovery and new science. That’s where these awards based at Northwestern University come into play. As the data coordinating center for the largest NIH-funded study addressing this condition to date, we will have the first line of sight for the new science and will be early in the steps needed for implementation.”

“The road ahead remains challenging, but these awards are a necessary and an important step forward,” said Dr. Patrick McCarthy, executive director of the Bluhm Cardiovascular Institute. “We look forward to the day we can translate this work into better care of these patients.” 

“At Northwestern Medicine, we are recognized as leading clinicians and investigators,” Yancy said. “This investment in our nation-leading team of cardiovascular specialists demonstrates that we are now recognized as leaders in data science. We are most pleased.”

The NIH grants (U54HL160273 and U01HL160279) were awarded to Northwestern Sept. 10 and Sept. 13, respectively. Other Northwestern principal investigators on the data coordinating center grant include Drs. Abel Kho, Yuan Luo and Denise Scholtens.