Recognizing Worsening Chronic Heart Failure as an Entity and an End Point in Clinical Trials

Heart failure has been considered a progressive and often fatal condition. However, clinical trials conducted during the last 2 decades among out patients with heart failure and reduced ejection fraction have shown that the negative trajectory of this syndrome can be altered with effective therapies improving the annual mortality risk from approximately 20% to approximately 5% to 8%. Here, Butler et al point out that a multicenter, multinational registry of inpatients and outpatients with heart failure is needed, from which cardiac structural and functional status, clinical course, and evolution of laboratory parameters can be ascertained and assessed longitudinally to aid the development of a precise definition of worsening chronic heart failure.