Evidence map›Paper›PMID 39904922›Full record

ArticleESC heart failure2025

Assessment of frailty in patients with heart failure: A new Heart Failure Frailty Score developed by Delphi consensus.

Cristiana Vitale, Emmanuelle Berthelot, Andrew J S Coats, Hill Loreena, Nancy M Albert, Michal Tkaczyszyn, Stamatis Adamopoulos, Lisa Anderson, Markus S Anker, Stefan D Anker and 51 more

Abstract readConsensus Statement
PubMed Full text at PMC Publisher
In one paragraph

Article in ESC heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  4. Palliative Care in Advanced Heart Failure.Current heart failure reports · 2026
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

61 authors.

Cristiana VitaleDepartment of Human Sciences and Promotion of Quality of Life, San Raffaele Open, University of Rome, Rome, Italy.
Emmanuelle BerthelotHospital Bicetre, Le-Kremlin Bicetre, France.
Andrew J S CoatsHeart Research Institute, Sydney, Australia.
Hill LoreenaSchool of Nursing & Midwifery, Queen's University, Belfast, UK.
Nancy M AlbertNursing Institute and Linda H. Kaufman Center for Heart Failure Treatment and Recovery, Cleveland Clinic, Cleveland, Ohio, USA.
Michal TkaczyszynDivision of Translational Cardiology and Clinical Registries, Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
Stamatis AdamopoulosHeart Failure and Transplant Unit, Onassis Cardiac Surgery Centre, Athens, Greece.
Lisa AndersonCardiovascular Clinical Academic Group, Molecular and Clinical Sciences Research Institute, University of London and St George's University Hospitals NHS Foundation Trust, London, UK.
Markus S AnkerDepartment of Cardiology CBF German Heart Center Charité, DZHK, BCRT, University Medicine Berlin FU and HU, Berlin, Germany.
Stefan D AnkerDepartment of Cardiology (CVK) of German Heart Center Charité; Berlin Institute of Health Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charité Universitätsmedizin, Berlin, Germany.
Derek BellNational Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC), London, UK.
Tuvia Ben-GalHeart Failure Unit, Cardiology Department, Rabin Medical Center, Petah Tikva and Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Vasiliki BistolaDepartment of Cardiology, Attikon University Hospital, National Kapodistrian University of Athens Medical School, Athens, Greece.
Biykem BozkurtWinters Center for Heart Failure, Cardiovascular Research Institute, Baylor College of Medicine and DeBakey VA Medical Center, Houston, Texas, USA.
Poppy BrooksRoyal Devon University Healthcare NHS Foundation Trust, Barnstaple, UK.
Miguel CamafortHeart Failure Unit, Internal Medicine Department, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain.
Juan Jesus CarreroDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Ovidiu ChioncelEmergency Institute for Cardiovascular Diseases 'Prof. C.C. Iliescu', University of Medicine Carol Davila, Bucharest, Romania.
Dong-Ju ChoiSeoul National University Bundang Hospital, Seongnam, South Korea.
Wook-Jin ChungDepartment of Cardiovascular Medicine, Gachon University Gil Medical Center, Incheon, Korea.
Wolfram DoehnerBerlin Institute of Health Center for Regenerative Therapies and Deutsches Herzzentrum der Charité, Department Cardiology (Virchow Klinikum), German Centre for Cardiovascular Research Partner Site Berlin and Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Daniel Fernández-BergésResearch Unit of Don Benito-Villanueva de la Serena Health Area, SES-Fundesalud, Villanueva de la Serena, Spain, University Institute for Biosanitary Research of Extremadura (INUBE), Badajoz, Spain.
Roberto FerrariCentro Cardiologico Universitario di Ferrara, University of Ferrara, Ferrara, Italy.
Mona FiuzatDivision of Cardiology, Duke University, Durham, North Carolina, USA.
Juan Esteban Gomez-MesaCardiology Department, Fundacion Valle del Lili, Health Sciences Department, Universidad Icesi, Cali, Colombia.
Finn GustafssonDepartment of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Institute of Heart Diseases, Wroclaw Medical University, University Hospital, Wroclaw, Poland.
Ewa JankowskaDivision of Translational Cardiology and Clinical Registries, Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
Seok-Min KangDivision of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University, Seoul, Republic of Korea.
Koichiro KinugawaThe Second Department of Internal Medicine, University of Toyama, Toyama, Japan.
Kamlesh KhuntiDiabetes Research Centre, University of Leicester, Leicester, UK.
F D Richard HobbsNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Christopher LeeWilliam F. Conell School of Nursing, Boston College, Newton, Massachusetts, USA.
Yuri LopatinRegional Cardiology Centre, Volgograd State Medical University, Volgograd, Russian Federation.
Matthew MaddocksCicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK.
Giuseppe MalteseDepartment of Diabetes and Endocrinology, Epsom & St Helier University Hospitals, Surrey, UK.
Elena Marques-SuleDepartment of Physiotherapy, University of Valencia, Valencia, Spain.
Yuya MatsueDepartment of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Òscar MiróEmergency Department, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain.
Brenda MouraFaculty of Medicine of Porto, Armed Forces Hospital, Porto, Portugal.
Massimo PiepoliClinical Cardiology, IRCCS Policlinico San Donato, Milano, Italy.
Piotr PonikowskiInstitute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
Giovanni PulignanoHeart Failure Clinic, Division of Cardiology/Coronary Care Unit, San Camillo Hospital, Rome, Italy.
Amina RakishevaCardiology Department, City Cardiology Center, Almaty, Kazakhstan.
Robin RayCardiovascular Clinical Academic Group, Molecular and Clinical Sciences Research Institute, University of London and St George's University Hospitals NHS Foundation Trust, London, UK.
Angela SciacquaInternal Medicine, Cardiovascular and Metabolic Diseases, Geriatrics Division, University Hospital R. Dulbecco, University Magna Graecia of Catanzaro, Catanzaro, Italy.
Petar SeferovicUniversity Medical Center, Medical Faculty University of Belgrade, Serbian Academy of Sciences and Arts, Belgrade, Serbia.
Trinidad Sentandreu-MañóDepartment of Physiotherapy, Advanced Research Methods Applied to Quality of Life Promotion (ARMAQoL), University of Valencia, Valencia, Spain.
Shirley SzeNIHR Leicester Biomedical Research Centre, University of Leicester, Glenfield Hospital, Leicester, UK.
Alan SinclairKing's College, London, and Foundation for Diabetes Research in Older People (fDROP), Droitwich Spa, UK.
Anna StrömbergDepartment of Health, Medicine and Caring Sciences and Department of Cardiology, Linköping University, Linköping, Sweden.
Olga TheouSchool of Physiotherapy and Department of Medicine, Dalhousie University, Halifax, Canada.
Hiroyuki TsutsuiInternational University of Health and Welfare, Fukuoka, Japan.
Izabella UchmanowiczFaculty of Nursing and Midwives, Wroclaw Medical University, Wrocław, Poland.
Maria Teresa VidanGeriatric Department, Hospital General Universitario Gregorio Maranón, Madrid, Spain; Biomedical Research Networking Center on Frailty and Healthy Aging, CIBERFES, Madrid, Spain.
Maurizio VolterraniDepartment of Human Sciences and Promotion of Quality of Life, San Raffaele Open, University of Rome, Rome, Italy.
Stephan von HaehlingDepartment of Cardiology and Pneumology, University of Göttingen Medical Center, DZHK (German Center for Cardiovascular Research) (DZHK), Partner Site Lower Saxony Göttingen, Göttingen, Germany.
Byungsu YooDivision of Cardiology, Wonju College of Medicine, Yonsei University, Yonsei, Korea.
Jian ZhangState Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Yuhui ZhangFuwai Hospital & National Center for Cardiovascular Diseases, Beijing, China.
Marco MetraDirector Cardiology Unit ASST Spedali Civili and University of Brescia, Brescia, Italy.
Giuseppe Massimo Claudio RosanoDepartment of Human Sciences and Promotion of Quality of Life, San Raffaele Open, University of Rome, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThe Heart Failure Frailty Score (HFFS) is a novel, multidimensional tool to assess frailty in patients with heart failure (HF). It has been developed to overcome limitations of existing frailty assessment tools while being practical for clinical use. The HFFS reflects the concept of frailty as a multidimensional, dynamic and potentially reversible state, which increases vulnerability to stressors and risk of poor outcomes in patients with HF. METHODS AND

resultsThe HFFS was developed through a Delphi consensus process involving 54 international experts. This approach involved iterative rounds of questionnaires and interviews, where a panel of experts provided their opinions on specific questions prepared by the Steering Committee. The experts were invited to vote and share their views anonymously, using a 5-point Likert scale over iterative rounds. An 80% threshold was set for agreement or disagreement for each statement. Twenty-two variables from four domains (clinical, functional, psycho-cognitive and social) have been selected for inclusion in the HFFS after the third round of the Delphi process. A shorter version (S-HFFS), including 10 variables, has also been developed for daily clinical use.

conclusionsThe HFFS is a new multidimensional tool for the identification of frailty in patients with HF. It should also enables healthcare providers to identify potential 'red flags' for frailty in order to develop personalized care plans. The next step will be to validate the new score in patients with HF.

Indexed as

Delphi TechniqueFrailtyGeriatric AssessmentHeart FailureAgedFemaleHumansMaleSurveys and QuestionnairesFrailtyHeart failureManagementPrognosisScore

Identifiers

PMID39904922
PMCPMC12055373

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.