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
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- Marco Metra
- Section of Cardiovascular Diseases, Department of Experimental and Applied Medicine University of Brescia Italy
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- Piotr Ponikowski
- Department of Cardiology Military Hospital Wroclaw Poland
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- Kenneth Dickstein
- Cardiology Division, University of Bergen Stavanger University Hospital Stavanger Norway
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- John J.V. McMurray
- Department of Cardiology, Western Infirmary Glasgow UK
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- Antonello Gavazzi
- Department of Cardiology Ospedali Riuniti di Bergamo Bergamo Italy
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- Claes‐Hakan Bergh
- Department of Cardiology Sahlgrenska University Hospital/Sahlgrenska Göteborg Sweden
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- Alan G. Fraser
- Department of Cardiology, Wales Heart Research Institute University of Wales College of Medicine Cardiff UK
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- Tiny Jaarsma
- Department of Cardiology, Programme Coördinator COACH University Hospital Groningen Groningen The Netherlands
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- Antonis Pitsis
- Department of Cardiac Surgery St. Luke's Hospital Panorama Thessaloniki Greece
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- Paul Mohacsi
- Swiss Cardiovascular Center Bern Head Heart Failure & Cardiac Transplant. University Hospital (Inselspital) Bern Switzerland
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- Michael Böhm
- Innere Medizin III, Universitätskliniken des Saarlandes Homburg/Saar Germany
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- Stefan Anker
- Applied Cachexia Research, Department of Cardiology Charité Campus Virchow‐Klinikum Berlin Germany
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- Henry Dargie
- Cardiac Department Western Infirmary Glasgow Scotland UK
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- Dirk Brutsaert
- Department of Cardiology, A.Z. Middellheim Hospital Univ. of Antwerp Antwerp Belgium
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- Michel Komajda
- Département de Cardiologie Pitié Salpêtrière Hospital Paris Cedex 13 France
説明
<jats:title>Abstract</jats:title><jats:p>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.</jats:p><jats:p>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.</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 9 (6-7), 684-694, 2007-05-11
Wiley
