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

Metra, M; Ponikowski, P; Dickstein, K; McMurray, JJ; Gavazzi, A; Bergh, CH; Fraser, AG; Jaarsma, T; Pitsis, A; Mohacsi, P; Böhm, M; Anker, S; Dargie, H; Brutsaert, D; Komajda, M; Heart, Failure Association of the European Society of Cardiology (2007). 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. European journal of heart failure, 9(6-7), pp. 684-94. Oxford: Oxford University Press 10.1016/j.ejheart.2007.04.003

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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.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Mohacsi, Paul

ISSN:

1388-9842

ISBN:

17481947

Publisher:

Oxford University Press

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:00

Last Modified:

04 May 2014 23:18

Publisher DOI:

10.1016/j.ejheart.2007.04.003

PubMed ID:

17481947

Web of Science ID:

000247148900020

URI:

https://boris.unibe.ch/id/eprint/26130 (FactScience: 65930)

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