Valvular heart disease contributes to an important portion of hospital admissions. It can progress to heart failure and death, and it ranks eighth among the causes of mortality due to cardiovascular diseases in Brazil. Patients with anatomically important and clinical repercussions, only interventional treatment (conventional surgery or transcatheter technique) is able to alter the natural course of the disease. The choice of intervention leads to the need for individualized evaluation of the patient, considering the presence of frailty. To measure frailty, we have several scores; however, there are limitations in listing which tools are more useful, faster, and easier. The traditional preoperative risk assessment scores, EuroSCORE II and Society of Thoracic Surgeons (STS), are not able to adequately assess frailty; sometimes, they make erroneous estimates regarding cardiovascular outcomes in frail patients. Routinely used isolated measurements, such as “gait speed” and “eyeball test”, also do not guarantee successful evaluation. Diagnosis of frailty requires a global analysis of the individual, where diverse variables regarding the physical, organic, and mental state are interpreted and correlated. For this task, there are frailty scores, especially the Katz Scale, Fried Scale, Rockwood Clinical Frailty Scale (CFS), Short Physical Performance Battery (SPPB), Bern Scale, and Columbia Scale. The Essential Frailty Toolset, compared to the other scores, have better performance and greater ability to identify patients at greater risk of poor outcomes after valve intervention. We still need further studies to understand the impact of frailty in patients with valve disease, as well as its interactions with the development of heart failure or worsening of the clinical condition.

David Provenzale Titinger is a medical doctor in Brazil, practing cardiology at Heart Institute of São Paulo University. Specialized in valvular diseases, acting in medical care for patients and research on the various topics of cardiology.