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充血性心力衰竭

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Aliskiren, Enalapril, or Aliskiren and Enalapril in Heart Failure Lifestyle Modifications for Preventing and Treating Heart Failure A Randomized Controlled Trial to Evaluate the Safety and Efficacy of Cardiac Contractility Modulation Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction Efficacy and Safety of Dapagliflozin in Heart Failure With Reduced Ejection Fraction According to Age: Insights From DAPA-HF When and how to use SGLT2 inhibitors in patients with HFrEF or chronic kidney disease From ACE Inhibitors/ARBs to ARNIs in Coronary Artery Disease and Heart Failure (Part 2/5) SGLT-2 Inhibitors and Cardiovascular Risk: An Analysis of CVD-REAL H2FPEF Score for Predicting Future Heart Failure in Stable Outpatients With Cardiovascular Risk Factors Longitudinal Change in Galectin-3 and Incident Cardiovascular Outcomes
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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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