title: Management of heart failure in the new era: the role of scores.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  We believe that multiparametric scores for risk assessment in heart failure are promising but their widespread use needs to be experienced.
authors.affiliation: 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.
authors.forename: Valentina
authors.initials: V
authors.lastname: Mantegazza
authors.forename: Roberto
authors.initials: R
authors.lastname: Badagliacca
authors.forename: Savina
authors.initials: S
authors.lastname: Nodari
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Parati
authors.forename: Carolina
authors.initials: C
authors.lastname: Lombardi
authors.forename: Salvatore
authors.initials: S
authors.lastname: Di Somma
authors.forename: Erberto
authors.initials: E
authors.lastname: Carluccio
authors.forename: Frank Lloyd
authors.initials: FL
authors.lastname: Dini
authors.forename: Michele
authors.initials: M
authors.lastname: Correale
authors.forename: Damiano
authors.initials: D
authors.lastname: Magrì
authors.forename: Piergiuseppe
authors.initials: P
authors.lastname: Agostoni
mesh_terms: D000208:Acute Disease; D002908:Chronic Disease; D019468:Disease Management; D005080:Exercise Test; D006333:Heart Failure / Q000628:therapy*; D006339:Heart Rate; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications*; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index