This is often a patient’s most important question, and also the most difficult for doctors to answer. In part, medical professionals may be reluctant to discuss statistical information with a patient, regarding a topic as serious as mortality. Also, with adherence to medications and lifestyle recommendations, a patient’s prognosis is often better than average.

Even so, some visitors have requested some type of statistical information on mortality of heart failure. It is VERY IMPORTANT for you to recognize that the following information applies to large groups. Individual prognosis should be discussed with your doctor.

Mortality has been shown in clinical trials to correspond to their clinically defined New York Heart Association (NYHA) status, where classes are defined on a scale of one to four (four being the worst functional status). Estimates of mortality rate per year for patient subgroups are as follows:

• Class II = 5-15%
• Class III = 20-50%
• Class IV = 30-70%

New York Heart Association (NYHA) Functional Class

• Class I: No limitation of functional activity
• Class II: Slight limitation of activity. Dyspnea and fatigue with moderate physical activity
• Class III: Marked limitation of activity. Dyspnea with minimal activity
• Class IV: Severe limitation of activity. Symptoms are present even at rest

The information listed is from a review article by Massie BM et al Am Heart J 1997; 133: 703-712.

Again, it is necessary for you and your family to discuss your prognosis with your doctor to plan for appropriate medical options and life activities.