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Updated: Feb 14, 2026

In Silico Clinical Trials for Cardiovascular Disease
Published on: May 27, 2022
The Current Focus of Heart Failure Clinical Trials
Naga Venkata Pothineni1, Ajoe John Kattoor1, Swathi Kovelamudi1
1Division of Cardiovascular Medicine, Department of Internal Medicine, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Insights
Ongoing heart failure (HF) clinical trials are mainly funded by non-governmental agencies. Research significantly favors HF with reduced ejection fraction (HFrEF) over HF with preserved ejection fraction (HFpEF).
Area of Science:
- Cardiology
- Clinical Research
- Public Health
Background:
- Heart failure (HF) represents a significant global health burden.
- Interventional clinical trials are crucial for evaluating new HF therapies.
- Understanding current trial characteristics is essential for advancing HF care.
Purpose of the Study:
- To identify and analyze the key features of ongoing interventional clinical trials for heart failure.
- To provide insights into the landscape of HF research.
Main Methods:
- Systematic review of interventional heart failure trials registered on ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform as of January 1, 2017.
- Data extraction included trial endpoints, sponsorship, funding sources, and patient population characteristics (specifically left ventricular ejection fraction status).
Main Results:
- Nearly half of the 794 included HF trials focused on clinical end points, and over a third on imaging end points.
- Industry and university sponsorships were prominent, accounting for approximately one-fourth and one-third of trials, respectively.
- A significant disparity exists in research focus, with 81.0% of trials targeting HF with reduced ejection fraction (HFrEF) compared to only 19.0% for HF with preserved ejection fraction (HFpEF).
Conclusions:
- The majority of ongoing heart failure clinical trials receive funding from non-governmental sources.
- Despite similar prevalence in the community, HF with preserved ejection fraction (HFpEF) is substantially underrepresented in clinical trial research compared to HFrEF.
Background:
Heart failure (HF) is a major global health problem. Clinical trials test efficacy, effectiveness, and safety of novel and emerging therapies in HF. We sought to determine the salient features of ongoing interventional clinical trials in HF.
Methods And Results:
We accessed the ClinicalTrials.gov registry of the National Institutes of Health (NIH) and the International Clinical Trials Registry Platform of the World Health Organization on January 1, 2017, and extracted pertinent information on current HF clinical trials for systematic review. Of 794 HF trials that met our inclusion criteria, almost one-half (49.1%) evaluated clinical end points and one-third (32.8%) examined imaging end points as primary outcomes. One-fourth (24.8%) were industry sponsored and one-third (35.6%) were university sponsored. The NIH and other United States federal agencies funded only 14 trials (1.8% of all trials; 10.7% of trials in the US). Among 536 HF trials with specified left ventricular ejection fraction status, 434 (81.0%) focused on HF with reduced ejection fraction (HFrEF) and only 102 (19.0%) trials targeted HF with preserved ejection fraction (HFpEF).
Conclusions:
Ongoing HF trials are predominantly sponsored by nongovernmental funding agencies. Although HFpEF occurs as commonly as HFrEF in the community, the number of clinical trials targeting HFpEF is substantially lower compared with HFrEF.
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