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- Title
Advanced chronic heart failure: A position statement from the Study Group on Advanced Heart Failure of the Heart Failure Association of the European Society of Cardiology
- Authors
Metra, Marco; Ponikowski, Piotr; Dickstein, Kenneth; McMurray, John J.V.; Gavazzi, Antonello; Bergh, Claes-Hakan; Fraser, Alan G.; Jaarsma, Tiny; Pitsis, Antonis; Mohacsi, Paul; Böhm, Michael; Anker, Stefan; Dargie, Henry; Brutsaert, Dirk; Komajda, Michel
- Abstract
Abstract: 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 fraction<30%, pseudonormal or restrictive mitral inflow pattern at Doppler-echocardiography; high left and/or right ventricular filling pressures; elevated B-type natriuretic peptides; 4) severe impairment of functional capacity demonstrated by either inability to exercise, a 6-minute walk test distance<300 m or a peak oxygen uptake<12–14 ml/kg/min; 5) history of >1 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.
- Subjects
HEART failure; CORONARY disease; PERFUSION; PHYSIOLOGICAL effects of oxygen; PATIENTS
- Publication
European Journal of Heart Failure, 2007, Vol 9, Issue 6/7, p684
- ISSN
1388-9842
- Publication type
Article
- DOI
10.1016/j.ejheart.2007.04.003