Advanced heart failure is often associated with multiorgan failure, frailty, and poor quality of life. It represents 10% of the 6.7 million adults in the United States afflicted with heart failure—a chronic, progressive, and debilitating syndrome.1,2  Within the first year of diagnosis of advanced heart failure, a heart transplant or an insertion of mechanical circulatory support (MCS), such as a left ventricular assist device (LVAD), must be employed to prolong a patient’s survival with improved quality of life. However, due to multiple organ failure, frailty is common in advanced heart failure, particularly in those who are candidates for an LVAD, and is a predictor of poor postoperative outcomes.3–5  Candidates for LVAD therapy are typically frail, encompassing deficient functional capacity and, to some extent, cachexia, which significantly contribute to long intubation time, prolonged critical care stay and hospitalization days, and high mortality rates.4,...

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