Advancing Genetics and Heart Failure: HFSA Steps Forward to Lead

Heart failure care is entering a pivotal moment—one in which genetics is no longer a future consideration, but a present-day imperative. The Heart Failure Society of America has long been committed to advancing science, improving patient outcomes, and leading where gaps in care persist… and HFSA is stepping forward to lead in one of the most important and under-addressed areas in cardiovascular medicine: genetics and heart failure.

Genetics Matter

Despite clear clinical guidelines and growing evidence, genetic testing remains vastly underutilized in patients with cardiomyopathy. Fewer than one percent of eligible patients currently receive genetic testing, leaving an estimated 300,000 individuals undiagnosed and under-managed from a genetic standpoint. This is not a theoretical gap… it is a real and consequential one.  

Genetic testing informs life-saving decisions, including intensified monitoring, treatment modification and arrhythmia risk assessment that may prompt consideration of implantable cardioverter-defibrillators. Genetic testing also informs the screening and management of family members of patients with heart failure. Genetics has become essential to delivering truly comprehensive heart failure care.

Closing the Gap

HFSA is uniquely positioned to address this implementation gap. Our multidisciplinary membership, robust research infrastructure, leadership in guideline development, and proven education and training platforms give us the ability to lead. HFSA co-authored the 2022 ACC/AHA/HFSA Heart Failure Guidelines recommending genetic testing and served as the lead author of the Genetic Evaluation of Cardiomyopathy—A Heart Failure Society of America Practice Guideline. We also bring together clinicians, researchers, genetic counselors, nurses, and advanced practice providers who understand how genetics fit into real-world heart failure workflows.
 
Central to our efforts is the REIMAGINE-HF Initiative, a comprehensive, implementation-science-driven program designed to close the gap between guidelines and practice. REIMAGINE-HF includes real-world analyses of testing gaps, development of care pathways and educational resources, a learning collaborative, and a pilot of clinic-based genetic testing across ten heart failure centers. Importantly, every component is structured for rigorous evaluation and publication, ensuring that HFSA’s leadership translates into durable, evidence-based change.

Shaping the Future

The momentum behind this enhanced role for HFSA in genetics is already evident. Genetics-focused abstracts, sessions, and Research Hub discussions were incorporated into the HFSA Annual Scientific Meeting 2025, and multiple manuscripts are in development for publication. HFSA is also working toward updated clinical practice resources in collaboration with the American College of Medical Genetics and Genomics, further strengthening the bridge between cardiology and genetics.
 
Equally important are our strategic partnerships. HFSA is collaborating with academic centers, federal partners, patient advocacy organizations, industry leaders, and genetic testing platforms. Support from corporate partners continues to grow, reflecting broad confidence in HFSA’s ability to lead responsibly, scientifically and ethically in this space. These partnerships allow us to accelerate innovation while keeping patients and families at the center of our work.
 
Looking ahead, HFSA is expanding its genetics and heart failure portfolio. New initiatives will include patient- and family-focused education, multimedia programs for providers and caregivers, genetics-focused scientific statements, targeted outreach to genetic counselors, and expanded genetics content within HF Stats. Together, these efforts represent a comprehensive strategy to educate, engage and equip the entire heart failure community.
 
This is a defining opportunity for HFSA. The need is clear, the science is strong and the field is asking for leadership. By advancing genetics and heart failure as a strategic priority, HFSA is not only responding to the moment, we are also shaping the future of heart failure care.

Kenneth B. Margulies, MD, FHFSA
HFSA President 2025-2026