Second Universal Definition of Heart Failure (2026)
Second Universal Definition of Heart Failure (2026)
Source: JACC, Circulation, European Heart Journal & Global Heart, July 2026; reported by TCTMD, July 1, 2026.
* Introduces a simpler way to classify HF moving away from rigid LVEF cutoffs.
• Classifies HF into three clinically actionable phenotypes:
* HFrEF – Heart failure with reduced EF.
* HFimpEF – Heart failure with improved EF.
* HFpEF – Heart failure with preserved EF.
• HFimpEF is not a cure—patients remain at risk of recurrent LV dysfunction, hospitalization, and sudden cardiac death, and should continue guideline-directed medical therapy (GDMT) with long-term follow-up.
• Reinforces the HF continuum: Stage A (at risk) → Stage B (Pre-HF)-Asymptomatic structural heart disease→ Stage C (symptomatic HF) → Stage D (advanced HF).
• Recommends classifying HF by its underlying etiology, not just ischemic vs nonischemic, to enable cause-specific treatment (e.g., amyloidosis, valvular, hypertensive, genetic, inflammatory, pregnancy-related, metabolic, toxic, etc.).
• Recognizes HF as a dynamic disease that may improve, remit, or progress, highlighting the importance of personalized prevention and management.
https://www.tctmd.com/news/second-universal-definition-hf-focuses-phenotypes-and-etiology?