The Heart Failure Research Institute (HFRI) at NewYork-Presbyterian was founded in 2024 by Nir Uriel, M.D., director of advanced heart failure, cardiac transplantation, and mechanical circulatory support at NewYork-Presbyterian, with the mission of advancing the understanding, prevention, and treatment of heart failure through research and to develop the next generation of scholars in the field.
HFRI heart failure experts and researchers across NewYork-Presbyterian, Columbia, and Weill Cornell Medicine lead and participate in some of the most cutting-edge translational research and clinical trials happening across the country. In less than three years, the institute has trained five HFRI scholars and 12 research fellows, awarded six research grants, and become involved in nearly two dozen cohort studies, randomized studies, and artificial intelligence projects.
Updates on some of the key research were recently shared at the 2026 Heart Failure Research Institute Symposium, an annual event that attracts global attendees to learn more about the latest advancements in heart failure care, and highlighted progress across six areas of focus:
- Heart failure mechanisms and innovations: From microbiome to interventions
- Decoding shock: Tissue, perfusion, and genomic insights
- Advancing mechanical support: Personalized strategies and clinical trials
- Precision transplantation: Biomarkers, immunity, and emerging tools
- Artificial intelligence and the future of cardiovascular care
- Integrated study design: Pragmatic trials, multicenter registries, and physiological studies
“We focus on three pillars: Research, education, and innovation. And we believe that if you combine these three, you can transform knowledge into real-world clinical impact,” says Dr. Uriel. “Major parts of that effort include continuing to expand our research portfolio, funding new ideas that improve patient care, and training the next generation of clinical and research leaders.”
Dr. Nir Uriel, right, with HFRI associate executive director Dr. Gabriel Sayer at the 2026 Heart Failure Research Institute Symposium.
Below are some research updates that were shared at this year’s symposium by HFRI advanced heart failure, transplant, and interventional cardiologists at NewYork-Presbyterian.
CardioClip: Early Enrollment and Interim Results
Many patients who undergo mitral transcatheter edge-to-edge repair (mTEER) — a minimally invasive transcatheter procedure that clips the mitral valve leaflets together to reduce mitral regurgitation — still experience heart failure symptoms after the procedure and may need to be hospitalized. The CardioClip study evaluates whether implanting a wireless pulmonary artery sensor after mTEER for remote hemodynamic monitoring can improve outcomes for these patients. The monitor relays information about how the heart is working without requiring the patient to come into the clinic or hospital, and it allows doctors to adjust medications and potentially prevent hospitalization or progression of heart failure symptoms. Michael Brener, M.D., shared updates on the study’s status and enrollment. Ultimately, researchers hope to enroll 60 patients and use the data to inform the design of a larger study that will evaluate an integrated treatment strategy for patients with mitral regurgitation undergoing mTEER.
RECOVER Study: Phenotypic and Genotypic Changes in Response to Left Ventricular Unloading With Impella 5.5
Adil Yunis, M.D., presented the RECOVER study, a longitudinal cohort study focused on patients in advanced cardiogenic shock who are supported by a temporary microaxial flow pump. The research aims to identify features of patients who achieve recovery of native heart function during support. Patients undergo repeated clinical, hemodynamic, imaging, lab, and microcirculation assessments while on the pump; those who proceed to advanced therapies also provide heart tissue samples for proteomic and genomic analysis. So far, 23 patients have been enrolled, and early data show improvements in microcirculation, heart function, cardiac biomarkers, and hemodynamics.
We focus on three pillars: Research, education, and innovation. And we believe that if you combine these three, you can transform knowledge into real-world clinical impact.
— Dr. Nir Uriel
SWITCH: Warfarin or Apixaban in HeartMate 3 Recipients
Ilan Richter, M.D., MPH, an HFRI scholar, provided updates on the soon-to-launch SWITCH trial, which assesses whether the blood thinner apixaban, an oral anticoagulant, can replace warfarin in patients who have been stable on a HeartMate 3 (HM3) left ventricular assist device (LVAD) for more than three months. Warfarin requires frequent international normalized ratio monitoring, which is burdensome for both patients and clinicians. Two small pilot trials had previously suggested that apixaban is safe with HM3. SWITCH is a multicenter, pragmatic, non-inferiority trial that will randomize 460 patients to either apixaban or warfarin, with the main endpoint being survival free of major hemocompatibility-related adverse events, such as stroke, pump thrombosis, or major bleeding, at one year.
TTV Monitoring: Torque Teno Virus as a Marker of Immune Status
Ersilia DeFilippis, M.D., spoke to an HFRI-funded study investigating whether torque teno virus (TTV) can serve as a marker of immune status after heart transplant. The amount of TTV in the blood reflects the strength of immune system suppression: High levels indicate a higher risk of infection, while low levels suggest a higher risk of rejection. TTV has been studied in kidney, lung, and liver transplants, but no prior published data exists for heart transplant patients. Mapping what a normal post-transplant TTV trajectory is after heart transplantation could help doctors tailor immunosuppression to each patient. To date, 62 patients have been enrolled, and 47 have received transplants. Early data show TTV levels rising over the first three months post-transplant and then stabilizing, consistent with findings in kidney transplant studies.
VALET-CMV: Valganciclovir vs. Letermovir in Heart Transplantation
Afsana Rahman, M.D., presented updates to VALET-CMV, a randomized trial at NewYork-Presbyterian, Columbia, and Weill Cornell Medicine that compares two drugs for preventing cytomegalovirus (CMV) infection in moderate- and high-risk heart transplant patients. The standard drug, valganciclovir, often lowers white blood cell counts, complicating care. The newer letermovir specifically targets CMV and has not shown this side effect in other types of transplants. Dr. Rahman and her colleagues recently published results from a retrospective study of 52 heart transplant patients, which found that nearly all regained normal white blood cell counts after switching to letermovir, with none developing CMV disease. Since enrollment began in September 2025, 33 patients have been randomized towards a target of 86. At six months, about a third experienced low white blood cell counts.
Our research questions grow out of our clinical experience, and we are always seeking to provide pragmatic interventions that will have significant and lasting impacts on patient care.
— Dr. Gabriel Sayer
AI in Action: Echo-VO2
Currently, one of the primary tools to diagnose advanced heart failure is cardiopulmonary exercise testing; however, this testing is often only available at specialized centers, meaning many patients may not receive the care they need. Kevin Clerkin, M.D., presented on Echo-VO2, a novel AI model developed by physicians, researchers, and engineers at NewYork-Presbyterian, Columbia, and Weill Cornell Medicine that estimates a patient's peak oxygen consumption (VO2) from a routine echocardiogram and standard health-record data. The model accurately identified patients’ low peak VO2 and performed consistently across patient subgroups. A prospective validation study to test whether the tool can flag high-risk patients earlier and speed their referral to heart failure specialists is planned for later this year.
BREATHE-HF Study Update: Baroreceptor Stimulation and Exercise Hemodynamics
HFRI scholar Bana Hadid, M.D., provided an update on the BREATHE-HF study, a prospective, multicenter trial investigating how baroreflex activation therapy (BAT) affects exercise physiology in patients with heart failure with reduced ejection fraction (HFrEF). BAT therapy utilizes an FDA-approved implanted device that stimulates receptors on the carotid artery to mitigate the overactive nervous system response characteristic of heart failure.
The BREATHE-HF study aims to enroll 58 patients across seven centers in the U.S. The primary endpoint will be change in peak exercise wedge pressure, assessed through exercise testing with heart catheterization performed before implantation and six months after device optimization. Currently, six patients have been enrolled at NewYork-Presbyterian and Columbia, with three having received the device. Six additional trial sites are preparing to commence enrollment.
“Clinical research is at the heart of what we do at HFRI,” says Gabriel Sayer, M.D., HFRI associate executive director and associate director of advanced heart failure, cardiac transplantation, and mechanical circulatory support at NewYork-Presbyterian. “Our research questions grow out of our clinical experience, and we are always seeking to provide pragmatic interventions that will have significant and lasting impacts on patient care.”
