Around 64 million people worldwide live with heart failure, a condition where the heart can no longer pump blood efficiently.
Shockingly, half of these people have a type of heart failure known as heart failure with preserved ejection fraction, or HFpEF.
Despite being so common, this group of patients has long been left without access to advanced heart pump treatments, relying only on medication or end-of-life care.
HFpEF is very different from the more familiar type of heart failure called HFrEF, or heart failure with reduced ejection fraction. In HFrEF, the heart muscle becomes weak and can’t pump blood properly. But in HFpEF, the heart’s pumping ability remains normal—it’s the filling that’s the problem.
The heart muscle becomes stiff and thick, leaving less room for blood to fill between beats. This stiffness makes it harder for the heart to supply the body with enough oxygen-rich blood, especially during physical activity. As a result, patients often experience breathlessness, fatigue, and reduced quality of life.
For decades, doctors have struggled to find effective treatments for HFpEF. Traditional heart pumps, known as ventricular assist devices (VADs), are designed for people with weak heart muscles.
These devices help push blood out of the heart, but for HFpEF patients, whose hearts are already pumping well but not filling properly, these pumps can actually make things worse. That’s why until now, mechanical heart pumps have not been an option for half of all heart failure patients.
Researchers at Monash University in Australia may have found a solution. A new study led by Ph.D. student Nina Langer has reimagined how a heart pump could be designed specifically for people with HFpEF.
Her research, published in the journal Annals of Biomedical Engineering, proposes a new device that improves blood flow, reduces stress on the heart, and may even act as a bridge to transplant for those waiting for donor hearts. For others who are not candidates for a transplant, it could serve as a long-term treatment option, giving them more years of life.
To carry out her research, Ms. Langer built a sophisticated cardiovascular simulator—a network of pumps, pipes, and valves that mimics the human heart and blood vessels.
This setup allowed her to test how different pump designs perform under real-life heart conditions. She discovered that modifying existing heart pumps could help manage blood flow in a way that suits HFpEF patients, paving the way for the first mechanical circulatory support system tailored to this condition.
Her work is now part of the Monash-led Artificial Heart Frontiers Program (AHFP), Australia’s largest cardiovascular device research initiative. The program is working to turn this concept into a real, clinical device that could one day transform the lives of millions of patients who currently have no treatment alternatives.
Ms. Langer explained that the biggest challenge lies in the structural differences of HFpEF hearts. These hearts tend to have smaller chambers and thicker walls, which means the standard heart pumps used for other types of heart failure do not fit well and may even cause harm.
A new, smaller, and smarter device could finally close this treatment gap. “Most people with HFpEF have no mechanical support options,” she said. “A dedicated pump could change that, giving them a real chance to live longer and better.”
To strengthen her findings, Ms. Langer collaborated with researchers at the Massachusetts Institute of Technology (MIT) to develop a computational model that can simulate how these heart pumps interact with human circulation.
The model was validated through lab experiments, giving engineers and clinicians a powerful tool to refine and optimize the next generation of heart devices.
Professor Shaun Gregory, Co-Director of the AHFP and Ms. Langer’s Ph.D. supervisor, emphasized that this research addresses a huge unmet medical need. “Over half of all heart failure patients have HFpEF, yet they have no mechanical device designed for them. This new study shows us a pathway forward,” he said.
The findings are exciting because they not only highlight the lack of existing options but also point toward a practical solution. By adapting technology originally designed for other heart conditions, researchers are opening doors for millions of people who previously had no hope beyond medication or palliative care.
If this new pump proves successful in clinical testing, it could revolutionize heart failure treatment, offering renewed energy and longer life to those who need it most.
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The study is published in Annals of Biomedical Engineering.
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