Frailty is increasingly recognized as a salient condition in patients with heart failure (HF) as previous studies have determined that frailty is highly prevalent and prognostically significant, particularly in those with advanced HF. Definitions of frailty have included a variety of domains, including physical performance, sarcopenia, disability, comorbidity, and cognitive and psychological impairments, many of which are common in advanced HF. Multiple groups have recently recommended incorporating frailty assessments into clinical practice and research studies, indicating the need to standardize the definition and measurement of frailty in advanced HF. Therefore, the purpose of this consensus statement is to provide an integrated perspective on the definition of frailty in advanced HF and to generate a consensus on how to assess and manage frailty. We convened a group of HF clinicians and researchers who have expertise in frailty and related geriatric conditions in HF, and we focused on the patient with advanced HF. Herein, we provide an overview of frailty and how it has been applied in advanced HF (including potential mechanisms), present a definition of frailty, generate suggested assessments of frailty, provide guidance to differentiate frailty and related terms, and describe the assessment and management in advanced HF, including with surgical and nonsurgical interventions. We conclude by outlining critical evidence gaps, areas for future research, and clinical implementation.

衰弱越来越被认为是心力衰竭 (HF) 患者的一个突出病症，因为先前的研究已确定衰弱非常普遍且具有预后意义，特别是对于晚期心力衰竭患者。虚弱的定义涵盖了多个领域，包括身体机能、肌肉减少症、残疾、合并症以及认知和心理障碍，其中许多障碍在晚期心力衰竭中很常见。多个团体最近建议将衰弱评估纳入临床实践和研究，表明需要标准化晚期心衰衰弱的定义和测量。因此，本共识声明的目的是为晚期心力衰竭的衰弱定义提供综合视角，并就如何评估和管理衰弱达成共识。我们召集了一群心力衰竭临床医生和研究人员，他们在心衰衰弱和相关老年疾病方面拥有专业知识，我们重点关注晚期心力衰竭患者。在此，我们概述了衰弱以及如何将其应用于高级心力衰竭（包括潜在机制），提出衰弱的定义，生成衰弱的建议评估，提供区分衰弱和相关术语的指导，并描述评估和管理晚期心力衰竭，包括手术和非手术干预。最后，我们概述了关键的证据差距、未来研究的领域和临床实施。