The Second Universal Definition of Heart Failure standardizes terminology by classifying HF phenotypes into reduced, preserved, and improved ejection fraction categories without rigid cutoffs.
The Second Universal Definition of Heart Failure standardizes terminology, updates HF classification based on ejection fraction trajectories, and addresses social determinants of health to improve global cardiovascular care.
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.
“Heart failure remains a major challenge that continues to grow globally, and inconsistencies in how it is defined have limited progress in research and treatment. This updated definition provides a clearer, more consistent framework to help clinicians identify risk earlier and guide more personalized treatment approaches that can help improve patient outcomes worldwide.”
This joint consensus document from the leading global cardiology societies updates the definition of heart failure, moving away from rigid ejection fraction cutoffs and introducing a universal classification of causes. It is a foundational document expected to influence clinical practice, research, and future guidelines worldwide.
Walsh et al. (Mon,) conducted a review in Heart failure. Second Universal Definition of Heart Failure was evaluated. The Second Universal Definition of Heart Failure standardizes terminology by classifying HF phenotypes into reduced, preserved, and improved ejection fraction categories without rigid cutoffs.