Observational studyESC heart failure2024
Heart failure 'the cancer of the heart': the prognostic role of the HLM score.
Observational study in ESC heart failure, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
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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.
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.
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Who cites it
12 citing papers in PubMed, 10 citations in OpenAlex.
- HLM Staging and Treatment Benefit of SGLT2i Across Heart Failure Severity.Journal of cardiovascular development and disease · 2026Article
- Left Ventricular Ejection Fraction in Heart Failure-A Parameter to Be Discontinued?Journal of clinical medicine · 2026Review
- Early in-hospital use of SGLT2i in heart failure patients with ischemic etiology.Cardiovascular drugs and therapy · 2026Observational
- Specific microRNAs for Heart Failure: Reference Values in Whole Blood.Biomedicines · 2025Article
- The Early Pharmacological Strategy with Inodilator, bEta-blockers, Mineralocorticoid Receptor Antagonists, Sodium-glucose coTransporter-2 Inhibitors and Angiotensin Receptor-neprylisin Inhibitors in Acute Heart Failure (PENTA-HF).Current vascular pharmacology · 2025Observational
- MicroRNA and Heart Failure: A Novel Promising Diagnostic and Therapeutic Tool.Journal of clinical medicine · 2024Review
- Identifying Demographic and Clinical Determinants of Ischemic Workup in Patients with Heart Failure.Journal of clinical medicine · 2024Article
- Strategy for an early simultaneous introduction of four-pillars of heart failure therapy: results from a single center experience.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2024Observational
- The Role of High-Sensitivity Troponin T Regarding Prognosis and Cardiovascular Outcome across Heart Failure Spectrum.Journal of clinical medicine · 2024Article
- Prognostic Assessment of HLM Score in Heart Failure Due to Ischemic Heart Disease: A Pilot Study.Journal of clinical medicine · 2024Article
- Heart failure 'the cancer of the heart': the prognostic role of the HLM score.ESC heart failure · 2024Observational
- Current Approaches to Worsening Heart Failure: Pathophysiological and Molecular Insights.International journal of molecular sciences · 2024Review
Corrections and comments
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Authors and funding
19 authors at 10 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsThe multi-systemic effects of heart failure (HF) resemble the spread observed during cancer. We propose a new score, named HLM, analogous to the TNM classification used in oncology, to assess the prognosis of HF. HLM refers to H: heart damage, L: lung involvement, and M: systemic multiorgan involvement. The aim was to compare the HLM score to the conventional New York Heart Association (NYHA) classification, American College of Cardiology/American Heart Association (ACC/AHA) stages, and left ventricular ejection fraction (LVEF), to assess the most accurate prognostic tool for HF patients. METHODS AND
resultsWe performed a multicentre, observational, prospective study of consecutive patients admitted for HF. Heart, lung, and other organ function parameters were collected. Each patient was classified according to the HLM score, NYHA classification, ACC/AHA stages, and LVEF assessed by transthoracic echocardiography. The follow-up period was 12 months. The primary endpoint was a composite of all-cause death and rehospitalization due to HF. A total of 1720 patients who completed the 12 month follow-up period have been enrolled in the study. 520 (30.2%) patients experienced the composite endpoint of all-cause death and rehospitalization due to HF. 540 (31.4%) patients were female. The mean age of the study population was 70.5 ± 12.9. The mean LVEF at admission was 42.5 ± 13%. Regarding the population distribution across the spectrum of HLM score stages, 373 (21.7%) patients were included in the HLM-1, 507 (29.5%) in the HLM-2, 587 (34.1%) in the HLM-3, and 253 (14.7%) in the HLM-4. HLM was the most accurate score to predict the primary endpoint at 12 months. The area under the receiver operating characteristic curve (AUC) was greater for the HLM score compared with the NYHA classification, ACC/AHA stages, or LVEF, regarding the composite endpoint (HLM = 0.645; NYHA = 0.580; ACC/AHA = 0.589; LVEF = 0.572). The AUC of the HLM score was significantly better compared with the LVEF (P = 0.002), ACC/AHA (P = 0.029), and NYHA (P = 0.009) AUC.
conclusionsThe HLM score has a greater prognostic power compared with the NYHA classification, ACC/AHA stages, and LVEF assessed by transthoracic echocardiography in terms of the composite endpoint of all-cause death and rehospitalization due to HF at 12 months of follow-up.
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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 Socratic graph.