NHLBI Working Group
Strategic Directions in Congestive Heart Failure
The National Heart, Lung, and Blood Institute convened a Working Group of
investigators on July 14, 2003, in Bethesda, Maryland. This Working Group brought
together experts in basic, clinical, and applied scientific research to address
the future research directions and needs in the area of congestive heart failure.
The Working Group evaluated the current state of knowledge, identified critical
gaps in our knowledge, understanding and application of research tools, and
developed specific recommendations to be used by the NHLBI in planning its future
research agenda in the area of heart failure.
The Working Group participants considered five major areas of discussion: 1)
diastolic heart failure; 2) genetics/genomics of heart failure; 3) treatment
of heart failure with drugs; 4) treatment of heart failure with transplantation
or devices; and 5) biomarkers and proteomics as applied to heart failure. The
Working Group addressed perceived needs and barriers in each of these areas
and developed recommendations further our understanding of the etiology, treatment
and prevention of heart failure.
The Working Group identified specific areas where the NHLBI could provide leadership
or direction in research efforts over the next five to ten years. The recommendations
of the Working Group are to:
Working Group Members
- Consider a clinical trial in patients with congestive heart failure involving
strategic approaches to the use of diuretics.
- Conduct a carefully designed treatment trial of aldosterone blockade in
patients with diastolic heart failure.
- Conduct clinical studies to define the underlying pathophysiology in heart
failure patients with preserved left ventricular function.
- Support the standardized collection of samples from patients in clinical
trials or population based studies for genomic/genetic and proteomic analysis.
- Develop appropriate studies to identify and eventually treat asymptomatic
individuals with left ventricular dysfunction.
- Develop strategies for the management of individuals in end-stage heart
- Develop a multidisciplinary approach to understanding the cardio-renal connection
in heart failure.
- Create investigative teams, such a clinical research networks, with access
to congestive heart failure patients to investigate new approaches to the
characterization, management, and treatment of patients with this disease.
Chair: Milton Packer, M.D., Department of Medicine, Columbia University College
of Physicians and Surgeons, New York, NY
- Daniel Burkhoff, M.D., Ph.D., Department of Medicine, Columbia University
College of Physicians and Surgeons
- Maria Rosa Costanzo, M.D., Edward Cardiovascular Institute, Naperville,
- Marvin A. Konstam, M.D., Department of Medicine, Tufts-New England Medical
- Daniel Levy, M.D., NHLBI, Framingham Heart Study, Framingham, MA
- Stephen Liggett, M.D., Department of Internal Medicine, University Of Cincinnati
- Barry Massie, M.D., Department of Medicine, University of California, San
- Bertram Pitt, M.D., Department of Internal Medicine, University of Michigan
- Bruce M. Psaty, M.D., Ph.D., M.P.H., Cardiovascular Health Research Unit,
University of Washington
- Margaret Redfield, M.D., Department of Internal Medicine, Mayo Clinic
- Lynne Warner Stevenson, M.D., Department of Medicine, Brigham and Women's
- Jennifer Van Eyk, Ph.D., Institute of Molecular Cardiobiology, Johns Hopkins
- Michael R. Zile, M.D., Department of Medicine, Medical University of South