Understanding contractility in heart failure

Heart failure affects 26 million people worldwide, hospitalizes more Americans per year than all cancers combined, and is becoming more common as the overall population ages and heart attack survival rates increase.1,2 The prevalence of heart failure in the U.S. is expected to grow from almost 6 million to more than 8 million people by 2030 and the cost of care is expected to increase 120% to almost $70 billion.

Heart failure is a progressive condition in which the heart becomes enlarged, thickened or rigid, causing it to become too weak or stiff to fill and pump blood throughout the body. Heart failure is the consequence of dysfunction within the sarcomere, a complex mechanism of interacting proteins driving heart contraction.

People living with heart failure may experience symptoms such as shortness of breath, fatigue, and coughing as they try to perform everyday activities. Heart failure has no cure and needs to be actively managed and treated in order to slow its progression. Despite available treatments, many heart failure patients have difficulty managing their disease. Heart failure remains the leading cause of hospitalization and readmission in people age 65 and older.1 30 to 50% of heart failure patients either die or are re-hospitalized within 60 days of admission, and almost half die within five years of hospital discharge.2

Learn about Heart Failure Rectangle

current therapies

Heart failure requires lifelong management of symptoms and new therapies to reduce the high mortality rate.4

Current therapies indirectly improve contractility and symptoms of heart failure.4

Treatment options vary depending on the symptoms but can include neurohormonal therapies and cardiac calcitropes.7-10

behind HF: the john crofut story

In the first documentary short in our “Behind HF” series, we meet John Crofut who is giving his all in every aspect of his life.

John Poster



  1. Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association. Circulation, 139(10),e56-e528
  2. Savarese G, Lund LH. Global Public Health Burden of Heart Failure. Card Fail Rev. 2017;3(1):7-11. doi:10.15420/cfr.2016:25:2
  3. What is Heart Failure? American Heart Association. Updated May 31, 2017. Accessed August 13, 2020. https://www.heart.org/en/health-topics/heart-failure/what-is-heart-failure
  4. Malik FI, Morgan BP. Cardiac myosin activation part 1: from concept to clinic. J Mol Cell Cardiol. 2011;51(4):454-461.
  5. Types of Heart Failure. American Heart Association. Accessed August 17, 2020. https://www.heart.org/en/health-topics/heart-failure/what-is-heart-failure/types-of-heart-failure
  6. Borlaug BA, Redfield MM. Diastolic and Systolic Heart Failure Are Distinct Phenotypes Within the Heart Failure Spectrum. Circulation. 2011;123(18):2006-2014.
  7. Malik FI, Hartman JJ, Elias KA, et al. Cardiac myosin activation: a potential therapeutic approach for systolic heart failure. Science. 2011;331(6023):1439-1443.
  8. Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA Guideline for the Management of Heart Failure. Circulation. 2013;128(16):e240-e327.
  9. Kass DA, Solaro RJ. Mechanisms and Use of Calcium-Sensitizing Agents in the Failing Heart. Circulation. 2006;113(2):305-315.
  10. Psotka MA, Gottlieb SS, Francis GS, et al. Cardiac Calcitropes, Myotropes, and Mitotropes: JACC Review Topic of the Week. J Am Coll Cardiol. 2019;73(18):2345-2353.
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