Tools for timing in heart failure: what–when–how?—the prognostic value of the Metabolic Exercise test data combined with Cardiac and Kidney Indexes score confirmed

Despite the great progress in the treatment of chronic heart failure (HF), it remains a condition associated with progressive deterioration and premature mortality.Modern therapies slow the rate of descent and some reset the survival curve upward, but decline is inevitable.There is, however, great heterogeneity in the progress in the individual HF patients.Survival in this population during the last two decades has significantly improved, due to new drugs, devices, and technologies.However, these new therapeutic tools are not always readily available and often costly and might be associated with complications.Therefore, to find the appropriate therapy for the right patients, evaluation of prognosis in HF is important.Additionally, patients at high risk of unfavourable outcomes could benefit from more intensive treatment and more frequent monitoring.To do this, current HF guidelines suggest the use of well-documented tests to establish the diagnosis and stratify patients for appropriate therapy. 1,2Importantly, this should be a process shared between the physician and the patient.