Determinants of prognosis in patients with heart failure

Heart failure is now the single most common inpatient diagnosis for patients 65 years of age and older and is growing. As decisions regarding heart transplantation are contemplated in an era of fixed resources, determination of prognosis becomes a critically important process. No single factor can be used to predict survival in this complex clinical syndrome, but a number of factors, which are highly interactive, can be deduced from laboratory studies. Left ventricular ejection fraction, exercise tolerance, and heart size are the most consistent and reliable measures of prognosis, but other variables are also useful. Despite the availability of numerous high technology measurements, determination of prognosis remains largely an art form.