Heart failure with reduced and preserved ejection fraction. Clinical and translational aspects.
Heart failure is associated with poor quality of life, is the most common cause of hospitalization, and is associated with high mortality and high costs to society. Heart failure is associated with reduced or preserved ejection fraction (HFrEF and HFpEF). Neurohormonal antagonist drugs improve outcomes in patients with HFrEF, and represent one of the greatest advances in the history of medicine. However, major unmet needs remain: In HFrEF, implementation of existing evidence based therapy in HFrEF is poor; in HFrEF, despite effective therapy and even with optimal implementation, the disease progresses to advanced heart failure, with few treatment options; and in HFpEF, the pathophysiology remains poorly understood and there are very limited treatment options.
Our research program in heart failure is very broad, from bench to bedside and to society. Our group consists of multiple PhD students, post-docs and fellows, statisticians and data managers, and research nurses. We also collaborate extensively with other groups at Karolinska, throughout Sweden, and globally.
- The registry-based, big data and epidemiology research is led by Gianluigi Savarese, MD, PhD.
- The HFpEF program, phase 2 trials, biomarker and imaging research is led by Camilla Hage, RN, PhD.
Highly qualified and motivated individuals interested in pursuing mechanistic, clinical or registry based research in the field of heart failure are welcome to contact our group.
Specific interests
- Registry based research in heart failure, using the Swedish Heart Failure Registry (SwedeHF; see https://kiheartfailure.github.io/shfdb3/) and the ESC heart failure registries (HF-LT and HF III).
- Designing and conducting pragmatic and registry based randomized controlled trials (RCTs and RRCTs) in heart failure, focusing on drug repurposing and new-use concepts for existing generic drugs. SPIRRIT-HFpEF is the first pragmatic trial in HFpEF, see https://www.ucr.uu.se/rikssvikt/rrct/spirrit-hfpef
- Heart failure with mildly reduced ejection fraction (HFmrEF): characterization and testing whether HFrEF therapy may be beneficial also in HFmrEF.
- Heart failure with preserved ejection fraction (HFpEF): risk factors, comorbidity and cause specific morbidity and mortality; focus on novel mechanisms and targets, including comorbidity driven systemic inflammation and microvascular dysfunction; and interventional trial design.
- Heart failure with reduced ejection fraction (HFrEF) and advanced heart failure: novel mechanisms for contractility; discovering novel targets and developing novel treatments targeting contractility: inotropes, myotropes, calcium sensitizers.
- Physiologic, neurohormonal and metabolic aspect of heart failure with preserved and reduced ejection fraction, and effects of heart transplantation and mechanical circulatory support (LVAD and ECMO).
- Early phase (phase 2) human interventional trials of existing drugs for novel indications (repurposing) and of novel drugs and peptide hormones as treatment for heart failure.
- Implementation science: How to optimize utilization of existing therapy for heart failure with reduced ejection fraction.