Heart transplantation: Assessment of heart failure mortality risk

Abstract

Heart failure (HF) presents with a wide spectrum of disease severity and with a broad risk of associated morbidity and mortality. Identification of individuals at high risk for HF death is important for assessment of candidacy for heart transplantation and mechanical circulatory assistance and, more broadly, for guiding pharmaceutical, surgical, or palliative interventions. In this article, we review and compare several of the HF risk prediction tools currently available, highlighting their clinical utilities and potential shortcomings. Risk prediction tools must be carefully selected, recognizing that their accuracy is likely to be greatest when used in patients most similar to those from whom the tool was developed. As HF is a dynamic condition, serial risk assessment at regular intervals and as patient clinical status changes is warranted, although clinical evidence to support this practice is limited.