Frailty in Heart Failure: Implications for Management

Vitale, Cristiana; Spoletini, Ilaria; Rosano, Giuseppe

doi:10.15420/cfr.2018.22.2

Cited by 82 publications

(67 citation statements)

References 48 publications

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“…The role of frailty has been increasingly recognized in cardiovascular diseases, and it has been recently identified as an independent factor for long-term mortality and hospital readmission in nondependent older adults with heart failure. 79,80 In line with that, the inclusion of a frailty indicator might improve the specificity of the available prognostic tools, providing more accurate patients' stratification. The frailty conceptual framework includes the Fried frailty phenotype model and the frailty index of Rockwood based on the progressive accumulation of deficit.…”

Section: Predictors Of Hospitalizationmentioning

confidence: 85%

“…Frailty is a common geriatric syndrome, characterized by the decline of physiological systems and reserve with inadequate response to minimal environmental stressors, leading to higher clinical vulnerability. The role of frailty has been increasingly recognized in cardiovascular diseases, and it has been recently identified as an independent factor for long‐term mortality and hospital readmission in nondependent older adults with heart failure . In line with that, the inclusion of a frailty indicator might improve the specificity of the available prognostic tools, providing more accurate patients’ stratification.…”

Section: Geriatric Clinical Predictors Of Hospitalizationmentioning

confidence: 99%

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Predictors of cardiovascular outcome and rehospitalization in elderly patients with heart failure

Rosa

Scagliola

Ghione

et al. 2018

Eur J Clin Investigation

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Background Heart failure (HF) is a major public health problem and represents the only cardiac disease continuing to increase in prevalence, in particular among elderly patients. The frequent rehospitalizations have a negative impact on quality of life of patients with HF, constituting a substantial cost for patients and the health system. The aim of this review was to look into biochemical, echocardiographic and socioeconomical parameters as predictors of clinical outcomes and rehospitalizations. Methods This narrative review is based on the material searched for and obtained via PubMed from January 2000 up to March 2018. The search terms we used were as follows: “elderly, heart failure, cardiovascular” in combination with “biomarker, echocardiography and hospitalization.” Results This review analyses the potential predictive role of biochemical and echocardiographic and socioeconomical parameters on clinical outcomes (particularly cardiovascular) and hospital readmissions in patients with chronic HF. We focused on risk stratification of elderly patients with HF, who constitute a category of frail subjects at higher risk for readmission to hospital. Conclusions In elderly subjects with chronic HF, the risk stratification could benefit of a multiparametric approach combining biochemical, echocardiographic, demographic and socioeconomical parameters, thus ensuring a better quality of life and at the same time a better allocation of financial resources.

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Section: Predictors Of Hospitalizationmentioning

confidence: 85%

Section: Geriatric Clinical Predictors Of Hospitalizationmentioning

confidence: 99%

Predictors of cardiovascular outcome and rehospitalization in elderly patients with heart failure

Rosa

Scagliola

Ghione

et al. 2018

Eur J Clin Investigation

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“…The frailty determinants in this work are in line with the views presented in the recent literature, emphasizing the combined effect of several determinants on FS in a cardiac patient. For example, the article by Vitale et al (2018) defines overlapping frailty that includes several domains such as cognitive deficits, functional impairment, physical deficits, mood disorders, undernutrition, or no social support. These accumulating deficits driven by FS determinants contribute to decreasing resources in stress resistance as showed in the recent literature.…”

Section: Discussionmentioning

confidence: 99%

“…These accumulating deficits driven by FS determinants contribute to decreasing resources in stress resistance as showed in the recent literature. As indicated by Vitale et al (2018), although this multidisciplinary approach should be a part of a holistic therapeutic plan to treat frail patients, there are still no relevant standards in clinical practice. In fact, clinicians based the FS rating for a long time solely on the physical dimension of frailty.…”

Section: Discussionmentioning

confidence: 99%

Multidimensional Approach to Frailty

et al. 2020

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The concept of frailty syndrome (FS) was first described in the scientific literature three decades ago. For a very long time, we understood it as a geriatric problem, recently becoming one of the dominant concepts in cardiology. It identifies symptoms of FS in one in 10 elderly people. It is estimated that in Europe, 17% of elderly people have FS. The changes in FS resemble and often overlap with changes associated with the physiological aging process of the body. Although there are numerous scientific reports confirming that FS is age correlated, it is not an unavoidable part of the aging process and does not apply only to the elderly. FS is a reversible clinical condition. To maximize benefits of frailty-reversing activities for patient with frailty, identification of its determinants appears to be fundamental. Many of the determinants of the FS have already been known: reduction in physical activity, malnutrition, sarcopenia, polypharmacy, depressive symptom, cognitive disorders, and lack of social support. This review shows that insight into FS determinants is the starting point for building both the comprehensive definition of FS and the adoption of the assessment method of FS, and then successful clinical management.

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“…More than half of all patients with acute decompensated HF were identified as frail, and many reports have described the relationship between chronic HF and frailty. 20,21 For both HF and preserved ejection fraction (HFpEF) and HF and reduced ejection fraction (HFrEF), frailty is associated with a higher risk of adverse outcomes. HFpEF is the most common type of HF among the elderly.…”

Section: Frailty and Heart Failurementioning

confidence: 99%

Current Understanding of the Role of Frailty in Cardiovascular Disease

Uchikado

Ikeda

Ohishi

2020

Circ J

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The elderly population is increasing because of increasing life expectancy, and the prevalence of frailty increases with age. Frailty commonly coexists with cardiovascular diseases (CVDs), such as coronary artery disease (CAD), heart failure (HF), aortic stenosis (AS), and atrial fibrillation (AF). Frail patients who undergo revascularization for CAD have higher complication rates; those with HF have a high prevalence of poor outcomes, and those with AF are vulnerable to increased stroke incidence. Moreover, frailty and asymptomatic severe AS were independent factors for mortality. The presence of frailty can lead to poor clinical outcomes, and frailty has been identified as a risk factor for mortality. Thus, the identification of frail patients who are at higher risks of disability and adverse clinical outcomes is important. In this review, the relationship between frailty and CVD is appraised and optimal treatments for frail patients are discussed.

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Frailty in Heart Failure: Implications for Management

Cited by 82 publications

References 48 publications

Predictors of cardiovascular outcome and rehospitalization in elderly patients with heart failure

Predictors of cardiovascular outcome and rehospitalization in elderly patients with heart failure

Multidimensional Approach to Frailty

Current Understanding of the Role of Frailty in Cardiovascular Disease

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