Heart failure: TNM-like classification

Abstract

Staging of heart failure represents a major issue in clinical practice. In this setting, the MOGE(S) classification was designed to be similar to the TNM classification used in oncology. Nevertheless, MOGE(S) nosology differs greatly from the key elements of the TNM classification, as well as its simplicity and clinical applicability. In fact, MOGE(S) acronym stands for morphofunctional characteristics (M), organ involvement (O), genetic or familial inheritance pattern (G), etiological information (E), and functional status (S). Recently, a new TNM-like classification for heart failure was proposed. This classification, named HLM, refers to heart damage arising from an initial stage of impaired systolic or diastolic function, without structural injury, to an advanced stage of biventricular dysfunction (H), different stages of lung involvement (L), and malfunction of peripheral organs such as the kidney, liver, and brain (M). HLM classification was influenced by the key elements of TNM staging: simplicity, clinical usefulness, efficacy for planning a therapeutic strategy, and ability to determine patient prognosis. HLM classification seems to be easily applied in the real world and valuable for balancing economic resources with the clinical complexity of patients.

Keywords: TNM; classification; heart failure.