The American Heart Association’s IMPLEMENT-EF program aims to reduce gaps in patient care, establish best practices for treating heart failure with preserved or mildly reduced ejection fraction
DALLAS, September 15, 2025 — The American Heart Association, a relentless force changing the future of health for everyone everywhere, is launching a new initiative to improve in-hospital care for people with heart failure with preserved ejection fraction (HFpEF) and heart failure with mildly reduced ejection fraction (HFmrEF). HFpEF and HFmrEF collectively account for up to 75% of all heart failure cases, yet clinical research and treatment evidence in HFpEF and HFmrEF is substantially limited compared with other types of heart failure.[1],[2]
The IMPLEMENT-EF quality improvement initiative will aim to address those challenges by mapping gaps in the patient journey to identify unmet needs and define ideal care models.
The percentage of blood that leaves the left ventricle with each heartbeat is measured by ejection fraction (EF). A normal EF is between 55% and 70%. HFpEF means an individual has heart failure but EF remains 50% or higher — the heart muscle contracts, but the left ventricle does not relax as it should during ventricular filling. HFmrEF means EF is reduced to 41%-49%.
Treatment for HFpEF and HFmrEF requires earlier recognition and prompt initiation of scientific evidence-based therapies to improve health outcomes.
This new three-year initiative, supported by Bayer, will engage a network of multidisciplinary care teams — including pharmacists — to ensure people are receiving and taking the appropriate medications, raise provider awareness of best care practices and improve adherence to scientific evidence-based therapies using insights from Get With The Guidelines® – Heart Failure data. Findings will inform the American Heart Association’s broader approach to patient care and help scale effective, replicable models nationwide.
To enhance clinical understanding and encourage best practices, the initiative will include a variety of professional educational offerings, such as a podcast series, eLearning module and live presentations. The Association will convene a Science Advisory Panel to guide development of these educational materials.
“Improving care for people experiencing heart failure with preserved or mildly reduced ejection fraction requires more than just clinical knowledge. It demands a coordinated, team-based approach,” said Mariell Jessup, M.D., FAHA, chief science and medical officer of the American Heart Association. “By bringing together diverse care teams and leveraging real-world data, this initiative will help elevate the standard of care and ultimately improve outcomes for millions of people living with heart failure.”
The Association has recruited 40 hospitals to take part in the inaugural program. Teams in these facilities will have the opportunity to collaborate with other hospitals and with nationally recognized experts, access exclusive educational resources and share successful quality improvement models.
“We are committed to advancing science that transforms patient care, especially in areas like HFpEF and HFmrEF, where gaps in evidence and treatment persist,” said Robert Perkins, M.D., M.P.H., FACP, vice president of U.S. medical affairs cardiovascular and renal at Bayer. “We’re proud to support this American Heart Association initiative to help identify and scale effective care models that can improve outcomes for the millions of people living with these forms of heart failure.”
Visit heart.org/IMPLEMENTEF to stay informed about insights from the initiative and more.
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About the American Heart Association
The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public’s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.
For Media Inquiries: 214-706-1173
Michelle Rosenfeld: michelle.rosenfeld@heart.org
For Public Inquiries: 1-800-AHA-USA1 (242-8721)
heart.org and stroke.org
[1] Savarese G, Stolfo D, Sinagra G, Lund L. Heart failure with mid-range or mildly reduced ejection fraction. Nat Rev Cardiol 19, 100–116 (2022). https://doi.org/10.1038/s41569-021-00605-5; Shah S, Kitzman D, et al. Phenotype-Specific Treatment of Heart Failure With Preserved Ejection Fraction: A Multiorgan Roadmap. Circulation. 2016. 134(1). https://doi.org/10.1161/CIRCULATIONAHA.116.02188; Shah, K, Xu, H, Matsouaka, R. et al. Heart Failure With Preserved, Borderline, and Reduced Ejection Fraction: 5-Year Outcomes. JACC. 2017 Nov, 70 (20) 2476–2486. https://doi.org/10.1016/j.jacc.2017.08.074.
[2] Savarese G, Stolfo D, Sinagra G, Lund L. Heart failure with mid-range or mildly reduced ejection fraction. Nat Rev Cardiol 19, 100–116 (2022). https://doi.org/10.1038/s41569-021-00605-5; Chris J Kapelios, Bahira Shahim, Lars H Lund, Gianluigi Savarese, Epidemiology, Clinical Characteristics and Cause-specific Outcomes in Heart Failure with Preserved Ejection Fraction. Cardiac Failure Review. 2023;9:e14. https://doi.org/10.15420/cfr.2023.03.