Advanced Heart Failure: Definition, Epidemiology, and Clinical Course

Heart Fail Clin. 2021 Oct;17(4):533-545. doi: 10.1016/j.hfc.2021.06.002. Epub 2021 Jul 15.

Abstract

Advanced heart failure (HF) is characterized by a progressive worsening of symptoms disabling for daily life, refractory to all therapies, and with high mortality. These patients may be candidates for life-prolonging therapies, such as heart transplantation (HT) or long-term (LT) mechanical circulatory support (MCS) or must just require palliative therapies. The 1-year survival after HT and/or LT-MCS is approaching 80% to 90%, being patient selection and timely referral to advanced HF centers critical for optimal outcomes. There is no single symptom, sign, or test that can identify these patients and different classifications are complementary and helpful for clinical decision-making.

Keywords: Advanced heart failure; Coordination and networking; Definition; Heart transplantation; Mechanical circulatory support; Prognosis; Referral criteria; Selection criteria.

Publication types

  • Review

MeSH terms

  • Heart Failure* / diagnosis
  • Heart Failure* / epidemiology
  • Heart Failure* / therapy
  • Heart Transplantation*
  • Heart-Assist Devices*
  • Humans
  • Palliative Care
  • Patient Selection