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AHA/ACC/ESC/WHF Expert Consensus Document: Second Universal Definition of Heart Failure (2026).

Created on 29 Jun 2026

Authors

Mary Norine Walsh, Lars Kober, Karen Sliwa, Marianna Adamo, Anubha Agarwal, Amitava Banerjee, Biykem Bozkurt, Maja Cikes, Albertino Damasceno, Akshay S Desai, G Michael Felker, Gail Hogan, Koichiro Kinugawa, Michelle Kittleson, Carolyn S P Lam, Theresa McDonagh, Marco Metra, Wilfried Mullens, Antonio Luiz P Ribeiro, Yolanda Vaughn, Amanda Vest

Published in

European heart journal. Jun 29, 2026. Epub Jun 29, 2026.

Abstract

Heart failure (HF) remains a pressing health concern, with rising prevalence globally. Subjectivity and ambiguity in the definition of HF and its antecedent stages have limited research, global surveillance, and prevention programs. To address this, several cardiac societies and foundations convened to standardize the definition of HF in 2021 and designated stage B or pre-HF to identify individuals at risk of developing HF. In subsequent years, substantial progress and changes have been made in aspects of preventing HF, improving HF diagnosis and management, and recognizing the importance of the affected individual's voice. Global differences and disparities in HF are better understood, as are causes and comorbidities leading to differences in care, which are also influenced by access to care. This consensus document presents the Second Universal Definition of Heart Failure, aiming to standardize terminology and facilitate a uniform approach for clinicians, researchers, health systems, and policymakers. In this definition, the classification of HF phenotypes moves away from rigid left ventricular ejection fraction cutoffs, instead grouping HF into reduced, preserved, and improved ejection fraction categories to better reflect clinical realities. A universal classification of HF causes is also proposed. The document also addresses the dynamic trajectories of HF-improvement, remission, and recovery-and highlights the impact of social determinants and geographic variation on HF risk and outcomes. By providing a comprehensive, standardized framework for HF definition and classification, this document seeks to improve prevention, early detection, and management of HF worldwide, ultimately enhancing patient care and advancing global cardiovascular health.

PMID:
42366993
Bibliographic data and abstract were imported from PubMed on 29 Jun 2026.

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