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充血性心力衰竭

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Ambulatory Inotrope Infusions in Advanced Heart Failure - A Systematic Review and Meta-Analysis A Fully Magnetically Levitated Circulatory Pump for Advanced Heart Failure Rationale and design of the comParIson Of sacubitril/valsartaN versus Enalapril on Effect on nt-pRo-bnp in patients stabilized from an acute Heart Failure episode (PIONEER-HF) trial Association Between Functional Impairment and Medication Burden in Adults with Heart Failure Rationale and design of the GUIDE-IT study: Guiding Evidence Based Therapy Using Biomarker Intensified Treatment in Heart Failure Frequency, predictors, and prognosis of ejection fraction improvement in heart failure: an echocardiogram-based registry study Angiotensin–Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction Is Cardiac Diastolic Dysfunction a Part of Post-Menopausal Syndrome? Baseline Features of the VICTORIA (Vericiguat Global Study in Subjects With Heart Failure With Reduced Ejection Fraction) Trial The year in cardiology: heart failure: The year in cardiology 2019
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Review ArticleVolume 7, Issue 12, December 2019

JOURNAL：JACC: Heart Failure Article Link

Frailty Is Intertwined With Heart Failure: Mechanisms, Prevalence, Prognosis, Assessment, and Management

A Pandey, D Kitzman, G Reeves. Keywords: aging; frailty; Fried phenotype; heart failure; physical function; quality of life

ABSTRACT

Frailty, a syndrome characterized by an exaggerated decline in function and reserve of multiple physiological systems, is common in older patients with heart failure (HF) and is associated with worse clinical and patient-reported outcomes. Although several detailed assessment tools have been developed and validated in the geriatric population, they are cumbersome, not validated in patients with HF, and not commonly used in routine management of patients with HF. More recently, there has been an increasing interest in developing simple frailty screening tools that could efficiently and quickly identify frail patients with HF in routine clinical settings. As the burden and recognition of frailty in older patients with HF increase, a more comprehensive approach to management is needed that targets deficits across multiple domains, including physical function and medical, cognitive, and social domains. Such a multidomain approach is critical to address the unique, multidimensional challenges to the care of these high-risk patients and to improve their functional status, quality of life, and long-term clinical outcomes. This review discusses the burden of frailty, the conceptual underpinnings of frailty in older patients with HF, and potential strategies for the assessment, screening, and management of frailty in this vulnerable patient population.
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