Now, Monash engineers are developing a breakthrough heart pump that could finally offer these patients the mechanical support they've never had.
New research suggests that a reimagined heart pump could offer hope for patients suffering from heart failure with preserved ejection fraction (HFpEF), a form of heart failure that has historically been difficult to treat. Unlike the more commonly known heart failure with reduced ejection fraction (HFrEF), HFpEF occurs when the heart muscle becomes stiff, making it harder for the heart to fill with blood between beats, despite maintaining a normal pumping function.
A Monash study proposes an innovative heart pump design could address the unique challenges of this condition by improving blood flow and alleviating the strain on the heart.
The study, published in the Annals of Biomedical Engineering, shows that a heart pump designed specifically for HFpEF could provide a bridge to transplant to keep patients alive while they wait for a donor heart, or even serving as a long-term solution for those without other options.
As part of her PhD program in mechanical engineering at Monash, study lead-author Nina Langer investigated how existing heart pumps could be adapted for HFpEF patients, helping drive innovation in next-generation devices and patient care.
"This major heart failure condition, known as HFpEF, has no dedicated mechanical circulatory support, leaving over half of all heart failure patients without a mechanical support option", Ms Langer said.
"Most of these patients have a heart that's stiff, with thickened walls and a smaller ventricle. This means standard ventricular assist devices don't fit well - and can even cause harm."
During her research, Ms Langer got hands-on with a purpose-built test rig, and designed a high-tech plumbing system with pipes, pumps and valves. This allowed her to simulate cardiovascular conditions, testing modifications to existing devices and making real-time adjustments.
These findings are contributing to the development of the first mechanical circulatory support device for HFpEF patients, which is now being developed by the Monash-led Artificial Heart Frontiers Program (AHFP), the largest cardiovascular device program in the country.
Ms Langer said the study highlighted a critical gap in heart failure treatment.
"The results underscore the need for dedicated heart pumps designed for this patient group, rather than repurposing devices developed for other types of heart failure. A dedicated pump could transform care for millions, offering a new lease on life for those currently left with few options."
In addition to the cardiovascular simulator, Ms Langer developed a cutting-edge computational model that was experimentally validated in collaboration with MIT (Massachusetts Institute of Technology), to further explore the adaptations of existing heart pumps and to help engineers and clinicians push the limits of innovation in the field.
Prof Shaun Gregory, one of Ms Langer's PhD supervisors and the Co-Director of the AHFP, said, "Nina's high-quality and translational research captures the unmet need for novel, targeted mechanical circulatory support for the largest cohort of patients with heart failure - over half of patients fall into the HFpEF category. While we've known of this unmet need for some time, this new study points to a clearer device development pathway."
