Advanced (Stage D) Heart Failure: A Statement From the Heart Failure Society of America Guidelines Committee

Fang, James C.; Ewald, Gregory A.; Allen, Larry A.; Butler, Javed; Canary, Cheryl A. Westlake; Colvin-Adams, Monica; Dickinson, Michael G.; Levy, Phillip D.; Stough, Wendy Gattis; Sweitzer, Nancy K.; Teerlink, John R.; Whellan, David J.; Albert, Nancy M.; Krishnamani, Rajan; Rich, Michael W.; Walsh, Mary Norine; Bonnell, Mark R.; Carson, Peter E.; Chan, Michael; Dries, Daniel L.; Hernandez, Adrian F.; Hershberger, Ray E.; Katz, Stuart D.; Moore, Stephanie; Rodgers, Jo E.; Rogers, Joseph G.; Vest, Amanda R.; Givertz, Michael M.

doi:10.1016/j.cardfail.2015.04.013

Cited by 306 publications

(205 citation statements)

References 141 publications

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“…Stage D heart Failure can be described as the presence of progressive and/or severe signs and symptoms of heart failure despite medical, surgical and device therapies. Patients generally in Stage D heart Failure have limited treatment modalities, morbidity is progressive and survival is decreased [3].…”

Section: Introductionmentioning

confidence: 99%

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The Benefits of Palliative Care Interventions for Patients with Heart Failure - A Literature Review

Hnyda¹,

Avadhani²

2017

J Palliat Care Med

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Palliative care is an underused resource with the heart failure patient population. Many of these patients suffer not only from physical alignments but mental, spiritual and financial ones. Heart failure patients face many challenges such as frequent readmissions and a declining quality of life. This not only affects the patients but their families as well. Early palliative care intervention can decrease hospital readmissions and improve quality of life. Although advances in medicine have allowed for the heart failure patient to have more options in prolonging their life, sudden cardiac death may still occur. This uncertainty with the trajectory of death makes it difficult for some health care providers to initiate early discussions of palliative care. Many heart failure patients and their families see heart failure as a benign disease which makes it seem unnecessary for early palliative care interventions. Palliative care, by some people, is perceived as imminent death and not as an improvement to the quality of life. These patients are not being offered appropriate palliative care until their disease has exhausted all treatment plans. Many medical providers do not feel comfortable discussing early palliative care interventions, which in turn can lead to the lack of initiation into the patient's heart failure treatment. Implementing a multidisciplinary team approach will allow cardiologists to work with other health care team members to provide for the highest quality of life. The purpose of this paper is to review the implementation process and benefits palliative care services offered to the heart failure patient community.

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Section: Introductionmentioning

confidence: 99%

“…increase leads to a decrease in medical compliance, increase in health care visits, decline in health status and an increase in mortality [3]. Heart failure places many burdens on the patients and their care givers which increases the need for palliative care interventions earlier in the diagnosis.…”

Section: Introductionmentioning

confidence: 99%

The Benefits of Palliative Care Interventions for Patients with Heart Failure - A Literature Review

Hnyda¹,

Avadhani²

2017

J Palliat Care Med

View full text Add to dashboard Cite

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“…The precise identification of HF patients at the highest risk of disease progression or death would enable physicians to intensify medical, surgical, and device therapy, including mechanical circulatory support implantation and heart transplantation, thus improving the prognosis of these individuals. 1,6 In addition, estimating prognosis for morbidity and mortality may help patients and their families understand the nature of illness and the reasons for a referral to supportive or palliative care in selected cases. 1,6 Many univariate predictors of poor prognosis in HF have been identified, including high New York Heart Association functional class, reduced left ventricular ejection fraction, abnormal right ventricular function, concomitant diastolic dysfunction, low peak oxygen consumption during cardiopulmonary exercise testing, and signs of reduced tissue perfusion (eg, low mean arterial pressure, renal dysfunction, and neurohormonal activation).…”

mentioning

confidence: 99%

“…1,6 In addition, estimating prognosis for morbidity and mortality may help patients and their families understand the nature of illness and the reasons for a referral to supportive or palliative care in selected cases. 1,6 Many univariate predictors of poor prognosis in HF have been identified, including high New York Heart Association functional class, reduced left ventricular ejection fraction, abnormal right ventricular function, concomitant diastolic dysfunction, low peak oxygen consumption during cardiopulmonary exercise testing, and signs of reduced tissue perfusion (eg, low mean arterial pressure, renal dysfunction, and neurohormonal activation). 1,6,9 It is well known that comorbidities influence the pathophysiology, management, and prognosis of advanced HF, contributing to increased morbidity and mortality.…”

mentioning

confidence: 99%

“…1,6 Many univariate predictors of poor prognosis in HF have been identified, including high New York Heart Association functional class, reduced left ventricular ejection fraction, abnormal right ventricular function, concomitant diastolic dysfunction, low peak oxygen consumption during cardiopulmonary exercise testing, and signs of reduced tissue perfusion (eg, low mean arterial pressure, renal dysfunction, and neurohormonal activation). 1,6,9 It is well known that comorbidities influence the pathophysiology, management, and prognosis of advanced HF, contributing to increased morbidity and mortality. [1][2][3][4][5][6] Murad et al 10 demonstrated that 60% of elderly patients with HF had at least 3 comorbidities, while only 2.5% of them had none.…”

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confidence: 99%

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