Next Article in Journal
Assessment of Metabolic and Nutritional Imbalance in Mechanically Ventilated Multiple Trauma Patients: From Molecular to Clinical Outcomes
Previous Article in Journal
Surveillance of Individuals with a Family History of Pancreatic Cancer and Inherited Cancer Syndromes: A Strategy for Detecting Early Pancreatic Cancers
Open AccessReview

Advanced Heart Failure and End-Stage Heart Failure: Does a Difference Exist

1
Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
2
Department of Medicine, Division of Cardiology University of Pennsylvania, Perelman School of Medicine, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA
*
Author to whom correspondence should be addressed.
Diagnostics 2019, 9(4), 170; https://doi.org/10.3390/diagnostics9040170
Received: 14 September 2019 / Revised: 28 October 2019 / Accepted: 29 October 2019 / Published: 1 November 2019
Advanced heart failure (AdHF) represents a challenging aspect of heart failure patients. Because of worsening clinical symptoms, high rates of re-hospitalization and mortality, AdHF represents an unstable condition where standard treatments are inadequate and additional interventions must be applied. A heart transplant is considered the optimal therapy for AdHF, but the great problem linked to the scarcity of organs and long waiting lists have led to the use of mechanical circulatory support with ventricular-assist device (VAD) as a destination therapy. VAD placement improves the prognosis, functional status, and quality of life of AdHF patients, with high rates of survival at 1 year, similar to transplant. However, the key element is to select the right patient at the right moment. The complete assessment must include a careful clinical evaluation, but also take into account psychosocial factors that are of crucial importance in the out-of-hospital management. It is important to distinguish between AdHF and end-stage HF, for which advanced therapy interventions would be unreasonable due to severe and irreversible organ damage and, instead, palliative care should be preferred to improve quality of life and relief of suffering. The correct selection of patients represents a great issue to solve, both ethically and economically.
Keywords: advanced heart failure; end stage heart failure; ventricular assist device; orthotopic heart transplant; HLM classification advanced heart failure; end stage heart failure; ventricular assist device; orthotopic heart transplant; HLM classification
MDPI and ACS Style

Severino, P.; Mather, P.J.; Pucci, M.; D’Amato, A.; Mariani, M.V.; Infusino, F.; Birtolo, L.I.; Maestrini, V.; Mancone, M.; Fedele, F. Advanced Heart Failure and End-Stage Heart Failure: Does a Difference Exist. Diagnostics 2019, 9, 170.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop