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August 28, 2026European Heart Journal
2026 ESC Guidelines for the management of heart failure
Lars KøberMarianna AdamoAnne‐Christine RuwaldDaniela TomasoniLisa AndersonCharlotte AnderssonJasper J. BrugtsOvidiu ChioncelErwan DonalPéter FerdinandyPardeep S. JhundFrancisco LeyvaRoberto LorussoMichael MadiganWilfried MüllensStefania PaolilloNicola RyanMaggie SimpsonHölger ThieleJens Jakob ThuneEmeline M. Van CraenenbroeckLinda W. van LaakeMariëtte VerbakelESC Guidelines Advisory GroupChristina ChristerssonMassimo F PiepoliAna AbreuSuleman AktaaFolkert W AsselbergsMichael A BorgerGiuseppe BorianiMargarita BridaRobert A ByrneClaudio CeconiC. ChrysohoouKevin DammanJean-Claude DeharoVictoria DelgadoFernando DominguezGloria FärberDaniel Fernández-BergésMarc FerriniEstelle GandjbakhchLuna GarganiBettina HeideckerBorja IbanezMassimo ImazioStefan JamesUlf LandmesserGregory Y H LipLars H LundS MacDonaldJohn William McEvoyLorenzo MenicantiBorislava MihaylovaInge MoelgaardChristian E MuellerLis NeubeckDaniela PiniEvgenij V PotapovAnne–Catherine PouleurEva PrescottAmina RakishevaBianca RoccaXavier RosselloAnna SanninoHatem Soliman AboumarieFelix C TannerIzabella UchmanowiczMattias Van HeetveldeMatthias WilhelmStefanos ZafeiropoulosKatja ZeppenfeldDaniel ZimpferA BanushiB. KichouHamayak SisakianNoemi PavoUlvi MirzoyevAna RoussoulieresZumreta KušljugićV. TraykovNina JakušConstantinos ErgatoudesAnna ChaloupkaHenrik WiggersAzza FarragPentti PõderKatariina PitkänenDamien LogeartKristian HellenkampKaterina Κ. NakaAnnamária KosztinInga Jóna IngimarsdóttirHelen CooneyR AslehSavina NodariMakhabbat BekbossynovaPranvera IbrahimiErkin Mirrakhimov
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“The overall burden of heart failure is expected to rise due to an ageing population and greater prevalence of risk factors and obesity. One of the key points we have tried to emphasise in the 2026 guidelines is the importance of prevention and starting treatment as early as possible.”
“The term 'guideline-directed medical therapy (GDMT)' was introduced more than 10 years ago. However, there have been further advances since then, creating some uncertainty as to what GDMT actually means today.”
“In some patients, 'acute' HF is not actually acute, but is a gradual deterioration. The guidelines also note that some less acute decompensated presentations can be managed in an ambulatory setting without the need for hospitalisation and this is in line with the new AHA/ACC/ESC/WHF universal definition of HF.”
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Køber et al. (2026) studied this question.