Universal definition and classification of heart failure: a report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure

Biykem Bozkurt , Andrew J.S. Coats , Hiroyuki Tsutsui , Biykem Bozkurt , Andrew J.S. Coats , Hiroyuki Tsutsui , Magdy Abdelhamid , Stamatis Adamopoulos , Nancy M. Albert , Stefan D. Anker , J. Atherton , Michael Böhm , Javed Butler , Mark H. Drazner , G. Michael Felker , Gerasimos Filippatos , Mona Fiuzat , Gregg C. Fonarow , Juan‐Esteban Gomez‐Mesa , Paul A. Heidenreich , Teruhiko Imamura , Ewa A. Jankowska , James L. Januzzi , Prateeti Khazanie , Koichiro Kinugawa , Carolyn S.P. Lam , Yuya Matsue , Marco Metra , Tomohito Ohtani , Massimo Piepoli , Piotr Ponikowski , Giuseppe Rosano , Yasushi Sakata , Petar Seferović , Randall C. Starling , John R. Teerlink , Orly Vardeny , Kazuhiro Yamamoto , Clyde W. Yancy , Jian Zhang , Shelley Zieroth
2021 European Journal of Heart Failure 1,374 citations

Abstract

Abstract In this document, we propose a universal definition of heart failure (HF) as a clinical syndrome with symptoms and/or signs caused by a structural and/or functional cardiac abnormality and corroborated by elevated natriuretic peptide levels and/or objective evidence of pulmonary or systemic congestion. We also propose revised stages of HF as: At risk for HF (Stage A), Pre‐HF (Stage B), Symptomatic HF (Stage C) and Advanced HF (Stage D). Finally, we propose a new and revised classification of HF according to left ventricular ejection fraction (LVEF). This includes HF with reduced ejection fraction (HFrEF): symptomatic HF with LVEF ≤40%; HF with mildly reduced ejection fraction (HFmrEF): symptomatic HF with LVEF 41–49%; HF with preserved ejection fraction (HFpEF): symptomatic HF with LVEF ≥50%; and HF with improved ejection fraction (HFimpEF): symptomatic HF with a baseline LVEF ≤40%, a ≥10 point increase from baseline LVEF, and a second measurement of LVEF > 40%.

Keywords

Ejection fractionHeart failureMedicineCardiologyInternal medicineNatriuretic peptide

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Publication Info

Year
2021
Type
article
Volume
23
Issue
3
Pages
352-380
Citations
1374
Access
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Biykem Bozkurt, Andrew J.S. Coats, Hiroyuki Tsutsui et al. (2021). Universal definition and classification of heart failure: a report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure. European Journal of Heart Failure , 23 (3) , 352-380. https://doi.org/10.1002/ejhf.2115

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DOI
10.1002/ejhf.2115