Abstract 17906: Usefulness of a New Proposed TNM-Like Classification for Heart Failure Staging: Comparison With the Classic NYHA
Introduction: NYHA classification is the most used for heart failure (HF), but it does not comprehend clinical features and other organs involvement due to HF.
Hypothesis: We propose a staging system for patients with HF called HLM similar to the TNM classification, used in oncology. The first parameter is “H” (HEART), analogous to the parameter “T” (TUMOR) of the TNM classification. The second parameter is “L” (LUNG); for the functional and anatomic proximity to the heart, the lungs might be considered as a lymph node station. Finally, in analogy with the concept of cancer metastasis, the third and last parameter of HLM classification is “M", that means the “malfunctioning” of the peripheral organs due to the condition of HF, such as kidney, liver and brain. We compared HLM with NYHA to achieve the most accurate prognosis of HF patients in terms of major adverse cardiovascular and cerebrovascular events (MACCE) and cardiac death.
Methods: We performed an observational registry of 651 consecutive HF patients. For each patient, all the parameters for cardiac, lung and other organs (kidney, liver, central nervous system, hematopoietic system) function have been examined. Each patient has been classified according to NYHA and HLM classifications. For HLM, as TNM, any alteration in heart (H instead of T), lung (L instead of N), organs as kidney, liver, brain and blood (M as Multiorgan damage like Metastasis), was evaluated. The MACCE and cardiac death rates were calculated at 30 days and 1-year follow-up.
Results: At 1 year-follow up, comparing to NYHA, HLM shows a greater area under the ROC curve (AUC) for MACCE as well as for cardiac death. (Fig. 1).
Conclusions: Basing on the preliminary results, HLM nosology seems to be more accurate to stratify risk of MACCE and cardiac death for HF patients, compared to NYHA classification. Data need to be confirmed in a greater population with a longer follow up.
Author Disclosures: P. Severino: None. S. Calcagno: None. M. Alfarano: None. M. Pucci: None. I. Ferrari: None. D. Alunni Fegatelli: None. A. Vestri: None. M. Mancone: None. S. Sciomer: None. F. Fedele: None.
- © 2016 by American Heart Association, Inc.