Advanced heart failure: a position statement of the Heart Failure Association of the European Society of Cardiology
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- Maria G. Crespo‐Leiro
- Complexo Hospitalario Universitario A Coruña (CHUAC) Instituto de Investigación Biomédica de A Coruña (INIBIC), CIBERCV, UDC La Coruña Spain
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- Marco Metra
- Cardiology University of Brescia Brescia Italy
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- Lars H. Lund
- Department of Medicine, Unit of Cardiology Karolinska Institute Stockholm Sweden
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- Davor Milicic
- Department for Cardiovascular Diseases University Hospital Center Zagreb, University of Zagreb Zagreb Croatia
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- Maria Rosa Costanzo
- Advocate Heart Institute Naperville IL USA
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- Gerasimos Filippatos
- Athens University Hospital Attikon Athens Greece
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- Finn Gustafsson
- Department of Cardiology Rigshospitalet Copenhagen Denmark
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- Steven Tsui
- Transplant Unit Royal Papworth Hospital Cambridge UK
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- Eduardo Barge‐Caballero
- Complexo Hospitalario Universitario A Coruña (CHUAC) Instituto de Investigación Biomédica de A Coruña (INIBIC), CIBERCV, UDC La Coruña Spain
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- Nicolaas De Jonge
- Department of Cardiology University Medical Center Utrecht Utrecht The Netherlands
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- Maria Frigerio
- Transplant Center and De Gasperis Cardio Center Niguarda Hospital Milan Italy
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- Righab Hamdan
- Department of Cardiology Beirut Cardiac Institute Beirut Lebanon
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- Tal Hasin
- Jesselson Integrated Heart Center Shaare Zedek Medical Center Jerusalem Israel
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- Martin Hülsmann
- Department of Internal Medicine II Medical University of Vienna Vienna Austria
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- Sanem Nalbantgil
- Department of Cardiology Ege University Hospital Izmir Turkey
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- Luciano Potena
- Heart and Lung Transplant Program Bologna University Hospital Bologna Italy
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- Johann Bauersachs
- Department of Cardiology and Angiology Medical School Hannover Hannover Germany
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- Aggeliki Gkouziouta
- Heart Failure and Transplant Unit Onassis Cardiac Surgery Centre Athens Greece
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- Arjang Ruhparwar
- Department of Cardiac Surgery University of Heidelberg Heidelberg Germany
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- Arsen D. Ristic
- Department of Cardiology of the Clinical Center of Serbia Belgrade University School of Medicine Belgrade Serbia
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- Ewa Straburzynska‐Migaj
- Department of Cardiology University of Medical Sciences Poznań Poland
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- Theresa McDonagh
- Department of Cardiology King's College Hospital London UK
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- Petar Seferovic
- Department of Internal Medicine Belgrade University School of Medicine and Heart Failure Center, Belgrade University Medical Center Belgrade Serbia
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- Frank Ruschitzka
- University Heart Center University Hospital Zurich Zurich Switzerland
説明
<jats:p>This article updates the Heart Failure Association of the European Society of Cardiology (ESC) 2007 classification of advanced heart failure and describes new diagnostic and treatment options for these patients. Recognizing the patient with advanced heart failure is critical to facilitate timely referral to advanced heart failure centres. Unplanned visits for heart failure decompensation, malignant arrhythmias, co‐morbidities, and the 2016 ESC guidelines criteria for the diagnosis of heart failure with preserved ejection fraction are included in this updated definition. Standard treatment is, by definition, insufficient in these patients. Inotropic therapy may be used as a bridge strategy, but it is only a palliative measure when used on its own, because of the lack of outcomes data. Major progress has occurred with short‐term mechanical circulatory support devices for immediate management of cardiogenic shock and long‐term mechanical circulatory support for either a bridge to transplantation or as destination therapy. Heart transplantation remains the treatment of choice for patients without contraindications. Some patients will not be candidates for advanced heart failure therapies. For these patients, who are often elderly with multiple co‐morbidities, management of advanced heart failure to reduce symptoms and improve quality of life should be emphasized. Robust evidence from prospective studies is lacking for most therapies for advanced heart failure. There is an urgent need to develop evidence‐based treatment algorithms to prolong life when possible and in accordance with patient preferences, increase life quality, and reduce the burden of hospitalization in this vulnerable patient population.</jats:p>
収録刊行物
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- European Journal of Heart Failure
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European Journal of Heart Failure 20 (11), 1505-1535, 2018-07-17
Wiley