title: Routine serial echocardiography in systolic heart failure: is it time for the heart failure guidelines to change?
abstract: The authors sought to obtain objective evidence for impacting the American College of Cardiology Heart Failure Guidelines for the routine use of serial echocardiography by assessing the reliability of the use of clinician-assessed patient symptoms and New York Heart Association (NYHA) functional classification compared with ejection fraction (EF) measured by echocardiography. A prospective study in 256 patients with systolic heart failure (HF) enrolled into an HF disease management program with EF ≤40% and at least 2 annual echocardiograms were included. Only 86 of 256 (33.5%) patients were correctly classified by NYHA class as showing improvement, no change, or deterioration as compared with echocardiographic assessments. Patients whose NYHA class showed no change between echocardiograms had the lowest survival rate. Quantification in patient's status with NYHA classification is not always a reliable assessment to evaluate prognosis and guide medical therapy for patients with systolic HF.
authors: Department of Medicine, University of Miami Miller School of Medicine, 1611 NW 12th Avenue, Miami, FL 33136, USA. khebert1@gmail.com
authors: Kathy
authors: K
authors: Hebert
authors: Francisco Yuri Bulcao
authors: FY
authors: Macedo
authors: Patrick
authors: P
authors: Trahan
authors: Leonardo
authors: L
authors: Tamariz
authors: Andre
authors: A
authors: Dias
authors: Ana
authors: A
authors: Palacio
authors: Lee M
authors: LM
authors: Arcement
mesh_terms: D004452:Echocardiography / Q000379:methods*; D005260:Female; D054143:Heart Failure, Systolic / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D011379:Prognosis; D011446:Prospective Studies; D013599:Systole