Statement from Dr. Brian H. Rowe: Investing in Heart Failure Research

Heart failure is a chronic, progressive and multifactorial condition where the heart is unable to pump sufficient blood to meet the body's circulatory and respiratory demands. Heart failure (HF) impacts at least 26 million people worldwide with over 650,000 Canadians aged 40 years and older living with a diagnosis of HF. Importantly, approximately 90,000 new cases are diagnosed in Canada each year, and that may increase following the COVID pandemic. While HF is more common in adults, congenital and acquired heart disease in children also causes HF, and is the leading cause of heart transplantation in children. Strikingly, people who develop HF are roughly six times more likely to die prematurely, with people from Indigenous communities and communities of colour being disproportionately impacted. Although the prevalence and incidence of HF is consistently higher among men than women, new emerging evidence around sex differences in disease presentation and pathophysiology suggests that perhaps this difference is not as large as previously thought. Patients with HF regularly access primary care providers, require specialist care, and present to emergency departments; and so it is not surprising that hospitalizations and readmissions for acute HF are extremely common in Canada. Finally, the direct costs of HF result in expenditures of more than $2.8 billion annually [ PDF (8.2 MB) - external link ] to the Canadian healthcare system.

Self-management and self-care in a virtual world was the focus of this year’s national HF Awareness Week campaign, which highlighted how the delivery of HF care has changed during the COVID-19 pandemic. Not only are people with HF at higher risk of serious illness or death if they contract COVID-19, the ongoing pandemic has created several barriers to accessing care. For example, fear of exposure to COVID-19 has prevented some individuals living with HF from seeking face-to-face care, resulting in delayed or disrupted disease management. Health service reductions have led to fewer cardiac investigations and procedures being performed across the globe. Furthermore, necessary public health measures to curb the spread of COVID-19 have isolated patients from friends, family, or other individuals, who could offer support in managing their condition. The ongoing social distancing measures have led care providers to pivot to virtual medical care options. The effectiveness and safety of these virtual care options for the management of HF compared to in-person clinical visits remains to be seen.

In order to address HF knowledge gaps and support the mobilization and coordination of HF evidence in Canada, our Institute is collaborating with Heart and Stroke Foundation of Canada (Heart & Stroke) and other partners on the HF Roundtable. The Roundtable will create the direction for heart failure care in Canada and help identify gaps that require research investment. In addition, also in collaboration with Heart & Stroke and other partners, we are leading a collaborative effort to fund a Heart Failure Research Network (Network). The Network will engage patients, people with lived/living experience , caregivers, Indigenous Elder or Knowledge KeepersFootnote 1, government representatives, policymakers, not-for-profit organizations, health care providers, and industry with researchers and clinicians to address this multifactorial health condition. The goals of this national, interdisciplinary Network are to improve our understanding of the underlying causes, pathophysiology and social determinants of HF, and to improve the prevention, detection, management, patient outcomes, quality of life, and care delivery. This funding opportunity was made possible through investments and insights from Heart & Stroke and our CIHR Institute partners (IA, IHSPR, III and IIPH). Other Network partners include Mitacs and the National Institutes of Health – National Heart, Lung, and Blood Institute.

On behalf of the ICRH team, I want to thank all of those who are working tirelessly to support those living with HF during these difficult times. I also want to thank our research community for their contributions and dedication to evidence generation and knowledge mobilization, which improves the quality of life for people living with HF.

Stay well and in touch!

Dr. Brian H. Rowe

Scientific Director, CIHR Institute of Circulatory and Respiratory Health
Professor, University of Alberta

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