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AHA/ACC/ESC/WHF Expert Consensus Document: Second Universal Definition of Heart Failure (2026)
Mary Norine Walsh1, Lars Kober2, Karen Sliwa3
1Ascension St. Vincent Heart Center, United States.
Global Heart
|July 6, 2026
Summary
The Second Universal Definition of Heart Failure standardizes terminology for heart failure (HF) and its stages. This aims to improve global prevention, diagnosis, and management of HF, enhancing patient care and cardiovascular health.
Area of Science:
- Cardiology
- Public Health
Background:
- Heart failure (HF) prevalence is rising globally, with ambiguous definitions hindering research and prevention.
- Standardizing HF definitions is crucial for global surveillance, diagnosis, and management.
- The 2021 consensus introduced Stage B (pre-HF) to identify at-risk individuals.
Purpose of the Study:
- To present the Second Universal Definition of Heart Failure, standardizing terminology and approach.
- To facilitate a uniform framework for clinicians, researchers, health systems, and policymakers.
- To improve global prevention, early detection, and management of heart failure.
Main Methods:
- A consensus document developed by cardiac societies and foundations.
- Revision of HF classification to include reduced, preserved, and improved ejection fraction categories.
- Inclusion of HF causes, dynamic trajectories (improvement, remission, recovery), social determinants, and geographic variations.
Main Results:
- A new, standardized definition and classification of heart failure phenotypes.
- Moves beyond rigid ejection fraction cutoffs to better reflect clinical realities.
- Addresses dynamic HF trajectories and the impact of social and geographic factors on outcomes.
Conclusions:
- The Second Universal Definition provides a comprehensive framework for heart failure.
- Aims to enhance global cardiovascular health through improved HF care.
- Standardization will facilitate better prevention, diagnosis, and management worldwide.
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