Mode of Death in Heart Failure With Preserved Ejection Fraction

Muthiah Vaduganathan, Ravi B. Patel, Alexander Michel, Sanjiv J. Shah, Michele Senni, Mihai Gheorghiade, Javed Butler*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

186 Scopus citations


Little is known about specific modes of death in patients with heart failure with preserved ejection fraction (HFpEF). Herein, the authors critically appraise the current state of data and offer potential future directions. They conducted a systematic review of 1,608 published HFpEF papers from January 1, 1985, to December 31, 2015, which yielded 8 randomized clinical trials and 24 epidemiological studies with mode-of-death data. Noncardiovascular modes of death represent an important competing risk in HFpEF. Although sudden death accounted for ∼25% to 30% of deaths in trials, its definition is nonspecific; it is unclear what proportion represents arrhythmic deaths. Moving forward, reporting and definitions of modes of death must be standardized and tailored to the HFpEF population. Broad-scale systematic autopsies and long-term rhythm monitoring may clarify the underlying pathology and mechanisms driving mortal events. There is an unmet need for a longitudinal multicenter, global registry of patients with HFpEF to map its natural history.

Original languageEnglish (US)
Pages (from-to)556-569
Number of pages14
JournalJournal of the American College of Cardiology
Issue number5
StatePublished - Feb 7 2017


  • epidemiology
  • mortality
  • outcomes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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