Targeting Frailty in Heart Failure

Frailty is a systemic syndrome characterized by impaired physiologic reserve, slowness, weakness, and wasting. It is associated with, but distinct from, aging, disability, and multimorbidity. Frailty is extremely common in patients with heart failure and portends a worse prognosis. The two syndromes worsen one another via complex molecular and cellular mechanisms which are not fully understood but include increased levels of stress hormones and cytokines. In this article, we discuss the mechanisms of frailty and review common frailty metrics. We review and summarize the literature on the impact of frailty in heart failure and discuss treatment and management options.