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June 25, 2026Journal of the American College of Cardiology

Mode of Death in Heart Failure With Preserved Ejection Fraction

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Key result

Sudden death causes ~28% of deaths in HFpEF alongside significant noncardiovascular competing risks.

Why the study?

Little is known about specific modes of death in patients with heart failure with preserved ejection fraction.

Population

Patients across 8 randomized clinical trials and 24 epidemiological studies with HFpEF

Design

Systematic review

Authors

MVMuthiah VaduganathanRPRavi B. PatelAMAlexander Michel

Discussion

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Overview

Noncardiovascular death is a major competing risk in HFpEF; leaves open precise arrhythmic sudden-death classification for targeted interventions.

Key Points

  • This research aims to understand the specific modes of death in patients with heart failure with preserved ejection fraction (HFpEF).
  • Conducted a systematic review of 1,608 HFpEF papers from 1985 to 2015.
  • Identified 8 randomized clinical trials and 24 epidemiological studies with mode-of-death data.
  • Advocated for standardized definitions and systematic autopsies in future research.
  • Sudden death accounts for approximately 25% to 30% of deaths in HFpEF but lacks a clear definition regarding arrhythmic deaths.
  • Noncardiovascular modes of death are a significant competing risk in HFpEF.
  • Emphasized the need for a longitudinal global registry to understand HFpEF's natural history.

Study Design

Type

Systematic Review

Structured PICO

P
Population
Systematic review of 8 randomized clinical trials and 24 epidemiological studies assessing mode-of-death data in patients with HFpEF.
O
Outcome
Mode of deathhard clinical

Noncardiovascular and sudden deaths are major modes of death in HFpEF, highlighting the need for standardized definitions and better characterization of underlying mechanisms.

Limitations

  • Definition of sudden death is nonspecific; it is unclear what proportion represents arrhythmic deaths.
  • Nonspecific definition of sudden death, making it unclear what proportion represents arrhythmic deaths

Cite This Study

Vaduganathan et al. (2017) conducted a systematic review in Heart failure with preserved ejection fraction (HFpEF). In patients with HFpEF, sudden death accounted for approximately 25% to 30% of deaths in trials, while noncardiovascular modes of death represent an important competing risk.

synapsesocial.com/papers/6a3cf28cb20054bd7fc0be0bhttps://doi.org/10.1016/j.jacc.2016.10.078
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