BACKGROUND Ambulatory patients with advanced heart failure (HF) are often considered for advanced therapies, including durable mechanical circulatory support (MCS). The Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profiles are a commonly used descriptor of disease severity in patients receiving MCS devices, but their role in defining the prognosis of ambulatory patients is less well established, especially for Profiles 6 and 7. METHODS Registry Evaluation of Vital Information on Ventricular Assist Devices in Ambulatory Life is a prospective observational study of 400 outpatients from 21 MCS and cardiac transplant centers. Eligible patients had New York Heart Association Class II to IV symptoms despite optimal medical and electrical therapies with a recent HF hospitalization, heart transplant listing, or evidence of high neurohormonal activation. RESULTS The cohort included 33 INTERMACS Profile 4 (8%), 83 Profile 5 (21%), 155 Profile 6 (39%), and 129 Profile 7 (32%). Across INTERMACS profiles, there were no differences in age, gender, ejection fraction, blood pressure, or use of guideline-directed medical therapy. A lower INTERMACS profile was associated with more hospitalizations, greater frailty, and more impaired functional capacity and quality of life. The composite end point of death, durable MCS, or urgent transplant at 12 months occurred in 39%, 27%, 24%, and 14% subjects with INTERMACS Profiles 4, 5, 6, and 7, respectively (p = 0.004). CONCLUSIONS Among ambulatory patients with advanced HF, a lower INTERMACS profile was associated with a greater burden of HF across multiple dimensions and a higher composite risk of durable MCS, urgent transplant, or death. These profiles may assist in risk assessment and triaging ambulatory patients to advanced therapies.

中文翻译：

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INTERMACS概况和动态性晚期心力衰竭患者的结局：REVIVAL Registry的报告。

背景技术患有高级心力衰竭（HF）的非卧床患者通常被考虑用于高级疗法，包括持久的机械循环支持（MCS）。机械辅助循环支持机构间注册表（INTERMACS）概况是接受MCS装置的患者疾病严重程度的常用描述，但在定义非卧床患者预后方面的作用尚不明确，尤其是对于概况6和7。动态生活中的心室辅助设备的重要信息评估是一项对来自21个MCS和心脏移植中心的400名门诊患者的前瞻性观察性研究。尽管最近进行了HF住院治疗，心脏移植，或高神经激素激活的证据。结果该队列包括33个INTERMACS配置文件4（8％），83个配置文件5（21％），155个配置文件6（39％）和129个配置文件7（32％）。在INTERMACS资料中，年龄，性别，射血分数，血压或使用指导性药物治疗均无差异。INTERMACS档案较低与住院次数增加，身体虚弱以及功能能力和生活质量受损有关。分别有INTERMACS资料4、5、6和7的受试者中，分别有39％，27％，24％和14％的受试者在12个月时发生了死亡，持久MCS或紧急移植的复合终点（p = 0.004）。结论在进行性HF的非卧床患者中，较低的INTERMACS资料与跨多个维度的HF负担更大，以及持久性MCS的复合风险较高，紧急移植，否则死亡。这些配置文件可以帮助进行风险评估，并使非卧床患者分流至更先进的治疗方法。