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Identifying Stage D Heart Failure: Data From the Most Recent Registries

Current Heart Failure Reports volume 16, pages 130–139 (2019)Cite this article

Abstract

Purpose of Review

Improving outcomes with durable mechanical circulatory support have led to expanding interest in the earlier recognition of patients destined to develop refractory heart failure (HF). The recognition of advanced HF has received increasing attention.

Recent Findings

The Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) registry developed patient profiles of advanced HF to describe the spectrum of patients with refractory HF undergoing mechanical circulatory support. These patient profiles have been extended to advanced HF patients on medical therapy and used to align outcomes with medical and device therapy in the Medical Arm of Mechanically Assisted Circulatory Support (MedaMACS) registries and the ROADMAP study.

Summary

Shared decision-making about treatment options for advanced HF requires individualized consideration of risks and benefits beyond survival. Future studies, including the ongoing Registry for Vital Information for VADs in Ambulatory Life (REVIVAL) study, will provide prognostic information for patients transitioning from stage C to stage D HF to help patients, caregivers, and physicians navigate the increasingly complex terrain of HF care.

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Author information

Affiliations

  1. Frankel Cardiovascular Center, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA

    Thomas M. Cascino & Keith D. Aaronson

  2. Center for Advanced Heart Disease, Division of Cardiovascular Medicine, Brigham and Women’s Hospital, 75 Francis St., Boston, MA, 02115, USA

    Garrick C. Stewart

Authors
  1. Thomas M. Cascino
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  2. Keith D. Aaronson
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  3. Garrick C. Stewart
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Correspondence to Garrick C. Stewart.

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Dr. Aaronson receives research support from Abbott and Medtronic and is a consultant for NuPulse, Medtronic, and Procyrion. All other authors declare that they have no conflict of interest.

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This article is part of the Topical Collection on Updates in Advanced Heart Failure

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Cascino, T.M., Aaronson, K.D. & Stewart, G.C. Identifying Stage D Heart Failure: Data From the Most Recent Registries. Curr Heart Fail Rep 16, 130–139 (2019). https://doi.org/10.1007/s11897-019-00433-2

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Keywords

  • Heart failure
  • Mechanical circulatory support
  • Registries
  • Ventricular assist device
  • Prognosis