The Ross classification for heart failure in children after 25 years: A review and an age-stratified revision

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Abstract

Accurate grading of the presence and severity of heart failure (HF) signs and symptoms in infants and children remains challenging. It has been 25 years since the Ross classification was first used for this purpose. Since then, several modifications of the system have been used and others proposed. New evidence has shown that in addition to signs and symptoms, data from echocardiography, exercise testing, and biomarkers such as N-terminal pro-brain natriuretic peptide (NT-proBNP) all are useful in stratifying outcomes for children with HF. It also is apparent that grading of signs and symptoms in children is dependent on age because infants manifest HF differently than toddlers and older children. This review culminates in a proposed new age-based Ross classification for HF in children that incorporates the most useful data from the last two decades. Testing of this new system will be important to determine whether an age-stratified scoring system can unify the way communication of HF severity and research on HF in children is performed in the future.

Original languageEnglish
Pages (from-to)1295-1300
Number of pages6
JournalPediatric Cardiology
Volume33
Issue number8
DOIs
StatePublished - Dec 2012

Keywords

  • Age-based Ross classification
  • Heart failure
  • Ross classification

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