Heart failure is a widespread syndrome involving several organs, still characterized by high mortality and morbidity, and whose clinical course is heterogeneous and hardly predictable.
In this scenario, the assessment of heart failure prognosis represents a fundamental step in clinical practice. A single parameter is always unable to provide a very precise prognosis. Therefore, risk scores based on multiple parameters have been introduced, but their clinical utility is still modest.
In this review, we evaluated several prognostic models for acute, right, chronic, and end-stage heart failure based on multiple parameters. In particular, for chronic heart failure we considered risk scores essentially based on clinical evaluation, comorbidities analysis, baroreflex sensitivity, heart rate variability, sleep disorders, laboratory tests, echocardiographic imaging, and cardiopulmonary exercise test parameters.
What is at present established is that a single parameter is not sufficient for an accurate prediction of prognosis in heart failure because of the complex nature of the disease. However, none of the scoring systems available is widely used, being in some cases complex, not user-friendly, or based on expensive or not easily available parameters.
We believe that multiparametric scores for risk assessment in heart failure are promising but their widespread use needs to be experienced.
aCentro Cardiologico Monzino, IRCCS, Milano
bPulmonary Hypertension Unit, Department of Cardiovascular and Respiratory Disease, “Sapienza” University of Rome, Roma
cSpedali Civili Hospital of Brescia, Universityof Brescia, Brescia
dDepartment of Health Science, University of Milano Bicocca & Department of Cardiology, S. Luca Hospital, IstitutoAuxologicoItaliano
eSleep Disorders Center, Department of Cardiology, S. Luca Hospital, IstitutoAuxologicoItaliano, Milano
fDepartment of Medical Sciences and Translational Medicine, “Sapienza” University of Rome, Sant’Andrea Hospital, Roma
gDivision of Cardiology, University of Perugia, Perugia
hCardiac Thoracic and Vascular Department, University of Pisa, Pisa
iDepartment of Cardiology, University of Foggia, “OspedaliRiuniti” OO. RR, Foggia
jDepartment of Clinical and Molecular Medicine, “Sapienza” University of Rome, Roma
kDepartment of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milano, Italy
Correspondence to Piergiuseppe Agostoni, MD, PhD, Centro Cardiologico Monzino, IRCCS, Via Parea 4, 20138 Milan, ItalyTel: +39 02 58002586; e-mail: email@example.com
Received 18 February, 2014
Revised 22 April, 2014
Accepted 30 April, 2014