A practical clinical definition for advanced chronic heart failure was proposed, identifying patients with severe symptoms, cardiac dysfunction, and poor prognosis despite optimal therapy.
Provides a standardized clinical definition for advanced chronic heart failure to identify patients with poor prognosis who require advanced therapeutic options.
Therapy has improved the survival of heart failure (HF) patients. However, many patients progress to advanced chronic HF (ACHF). We propose a practical clinical definition and describe the characteristics of this condition. Patients that are generally recognised as ACHF often exhibit the following characteristics: 1) severe symptoms (NYHA class III to IV); 2) episodes with clinical signs of fluid retention and/or peripheral hypoperfusion; 3) objective evidence of severe cardiac dysfunction, shown by at least one of the following: left ventricular ejection fraction1 HF hospitalisation in the past 6 months; 6) presence of all the previous features despite optimal therapy. This definition identifies a group of patients with compromised quality of life, poor prognosis, and a high risk of clinical events. These patients deserve effective therapeutic options and should be potential targets for future clinical research initiatives.
Metra et al. (2007) conducted a review in Advanced Chronic Heart Failure. A practical clinical definition for advanced chronic heart failure was proposed, identifying patients with severe symptoms, cardiac dysfunction, and poor prognosis despite optimal therapy.