Heart Failure Seminar: Focus on Assessment of HF Patients for Advanced HF Therapies (OnDemand)-Focus on Assessment of HF Patients

Focus on Assessment of HF Patients

Pdf Summary

The HFSA HF Seminar titled "Focus on Assessment of HF Patients for Advanced HF Therapies" held on October 28, 2025, provided a comprehensive review of identifying and managing advanced heart failure (HF), particularly for patients eligible for advanced therapies like heart transplantation and left ventricular assist devices (LVADs).<br /><br />Dr. Melissa Lyle defined Stage D (advanced) HF as severe symptoms interfering with daily life despite guideline-directed medical therapy (GDMT), recurrent hospitalizations, and significant cardiac dysfunction. Early referral to specialized HF centers is crucial to improve outcomes and avoid complications like pulmonary hypertension and end-organ damage. Clinical indicators for referral include refractory symptoms, hospitalization frequency, declining exercise tolerance (peak VO2 12-14 mL/kg/min), inotrope dependence, and evidence of end-organ dysfunction.<br /><br />Joy Coles emphasized the thorough evaluation process before advanced therapies. Key referral triggers include NYHA Class IIIb-IV symptoms despite maximal GDMT, recurrent hospitalizations, low cardiac output signs, and worsening renal function. The assessment involves clinical, psychosocial, and contraindication evaluations. Absolute contraindications include active infections, malignancy, irreversible pulmonary hypertension, and poor social support. Multidisciplinary care coordination and consideration of social determinants of health are vital to optimize patient eligibility and success.<br /><br />Dr. Jordan Hoffman reviewed surgical aspects of heart transplantation, including donor and recipient selection, matching (highlighting the superiority of predicted heart mass (PHM) ratio over height or weight for size matching), operative approach, and postoperative management. Candidate assessment balances multiple factors such as comorbidities, frailty, prior surgeries, and social support, aiming to “get to yes.” Postoperative care focuses on hemodynamics, immunosuppression, and rehabilitation.<br /><br />Overall, the seminar reinforced early identification, timely referral, comprehensive evaluation, and multidisciplinary management as keys to improving survival in advanced HF. Advanced therapies like LVADs and heart transplantation, alongside palliative care options, remain critical tools, and evolving practices continue to refine patient selection and outcomes.

Keywords

Advanced Heart Failure

Heart Transplantation

Left Ventricular Assist Devices

Stage D Heart Failure

Guideline-Directed Medical Therapy

Referral Criteria

Multidisciplinary Care

Predicted Heart Mass Ratio

Postoperative Management

Palliative Care