IIIB or not IIIB: a previously unanswered question.

Journal of Cardiac Failure
Jennifer T ThibodeauMark H Drazner

Abstract

The term New York Heart Association (NYHA) class IIIB has been used increasingly in clinical medicine, including as an inclusion criteria for many clinical trials assessing left ventricular assist devices (LVADs). Indeed, NYHA class IIIB is incorporated in the Food and Drug Administration's approved indication for the Heartmate II. However, on review of the medical literature, we found that there is no consensus definition of NYHA class IIIB. Until the ambiguity is resolved, we suggest that this designation not be used in clinical practice or by investigators leading clinical trials assessing therapies which convey substantial risk to patients and therefore require clarity in describing the enrolled patient population. With ongoing improvements in LVADs, this therapy will increasingly be considered in patients less sick than those who require inotropic support, providing urgency to establish a consensus system of classifying such patients who nevertheless fall within the spectrum of advanced heart failure. Herein we propose a modification of the standard NYHA classification system which can be used to fill this void.

References

Jan 17, 2002·The New England Journal of Medicine·E A RoseUNKNOWN Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) Study Group
May 30, 2002·European Journal of Heart Failure·Monica R ShahChristopher M O'Connor
Dec 7, 2002·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Laila HellgrenElisabeth Ståhle
Jun 25, 2003·The Annals of Thoracic Surgery·Wayne E RichenbacherUNKNOWN REMATCH Investigators
Apr 28, 2004·The American Journal of Cardiology·Dariush MozaffarianWayne C Levy
Dec 3, 2004·Journal of Cardiovascular Electrophysiology·Tamara HorwichLeslie Saxon
Mar 5, 2005·European Journal of Nuclear Medicine and Molecular Imaging·Cecilia MariniGianmario Sambuceti
Mar 15, 2006·Circulation·Wayne C LevyMilton Packer
Sep 2, 2008·European Journal of Heart Failure·Urban AlehagenLars-Ake Levin
Oct 18, 2008·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·James K KirklinJames B Young
Oct 23, 2008·The American Journal of Cardiology·Birgitta Blakstad NilssonMay Arna Risberg
Oct 24, 2008·European Journal of Heart Failure·Markku S NieminenToni Sarapohja
Mar 17, 2009·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Wayne C LevyUNKNOWN REMATCH Investigators
Jun 2, 2009·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Lynne Warner StevensonJames K Kirklin
Jul 18, 2009·Journal of the American College of Cardiology·Francis D PaganiUNKNOWN HeartMate II Investigators
Nov 19, 2009·The New England Journal of Medicine·Mark S SlaughterUNKNOWN HeartMate II Investigators
Feb 4, 2010·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·James K KirklinJames B Young
Apr 24, 2010·Journal of the American College of Cardiology·Joseph G RogersUNKNOWN HeartMate II Investigators
Jul 9, 2010·Journal of Cardiac Failure·UNKNOWN Heart Failure Society of AmericaMary N Walsh
Oct 12, 2010·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Bart P MeynsDaniel Burkhoff
Nov 9, 2010·Journal of Cardiac Failure·J Timothy Baldwin, Douglas L Mann
Dec 21, 2010·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Andrew J BoyleJeffrey J Teuteberg
Jan 11, 2011·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·James K KirklinJames B Young
Apr 13, 2011·Circulation·Garrick C Stewart, Lynne W Stevenson

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Citations

Jan 4, 2013·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·C Crawford Mechem
Mar 29, 2020·Journal of the American College of Cardiology·Maya GuglinUNKNOWN ACC Heart Failure and Transplant Member Section and Leadership Council

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