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Advanced heart failure: from definitions to therapeutic options

Andrea Garascia1, Matteo Palazzini1, Andrea Tedeschi1

  • 1De Gasperis Cardio Center, Ospedale Niguarda, Piazza Ospedale Maggiore 3, Milano, Italia.

European Heart Journal Supplements : Journal of the European Society of Cardiology
|May 1, 2023
PubMed

Insights

Advanced heart failure (AHF) requires prompt referral to specialized facilities. This review details AHF management, including diagnosis and advanced therapies like heart transplantation (HTx) and left ventricular assist devices (LVAD).

Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Advanced heart failure (AHF) is a critical stage of heart failure (HF) with a poor prognosis.
  • Despite medical advancements, outcomes for AHF patients remain challenging.

Purpose of the Study:

  • To review the definition, prognosis, pathophysiology, and management of AHF.
  • To emphasize timely referral to AHF facilities for optimal patient care.
  • To describe the diagnostic and therapeutic workup in an Italian AHF hub.

Main Methods:

  • Comprehensive literature review on AHF.
  • Analysis of diagnostic and therapeutic protocols in an AHF hub.
  • Focus on phenotypical patient characterization for advanced therapies.

Main Results:

  • AHF management requires a multidisciplinary approach.
  • Detailed phenotyping is crucial for selecting patients for heart transplantation (HTx) or left ventricular assist devices (LVAD).
  • Timely referral significantly impacts patient outcomes.

Conclusions:

  • Early identification and referral to specialized AHF centers are vital.
  • Personalized phenotypical assessment guides candidacy for advanced therapies like HTx and LVAD.
  • Integrated management strategies improve the prognosis for advanced heart failure patients.

Keywords:
Advanced heart failureHeart transplantationMechanical circulatory support

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