[How to evaluate a patient with heart failure? Round table].
Evaluation of heart failure is the first step prior to introduction of an adapted therapeutic strategy. Three principal objectives must be defined: 1) identify the cause of heart failure, which may directly guide subsequent treatment (valvular heart disease, coronary artery disease, etc.); 2) evaluate the repercussions of heart failure on everyday life: evaluation of quality of life, severity of functional disorders and reduction of the everyday capacity. This evaluation is the most delicate as it is based on clinical interview: evaluation of the various NYHA stages lacks precision and reproducibility. The stress test with measurement of oxygen consumption appears to constitute an acceptable evaluation technique; 3) evaluation of the prognosis. Many studies have demonstrated precise relationships between life expectancy and a number of criteria, alteration of myocardial function, echocardiographic findings, ejection fraction, cardiac output and even an AP chest x-ray. Although statistically valid, these criteria have a limited application in individual patients. Evaluation of all these parameters is the most accurate way to predict the subsequent course of the disease which therefore allows a more accurate choice of treatment and subsequent evaluation of their efficacy.
Guérot
C
C
Service de Cardiologie, Hôpital Boucicaut, Paris.
Desnos
M
M
Hagège
A
A
Grenier
O
O
Besse
B
B
D006333:Heart Failure / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D006334:Heart Function Tests; D006801:Humans; D008722:Methods; D011379:Prognosis; D011788:Quality of Life