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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
Author(s) -
Bozkurt Biykem,
Coats Andrew J.S.,
Tsutsui Hiroyuki,
Abdelhamid Ca Magdy,
Adamopoulos Stamatis,
Albert Nancy,
Anker Stefan D.,
Atherton John,
Böhm Michael,
Butler Javed,
Drazner Mark H.,
Michael Felker G.,
Filippatos Gerasimos,
Fiuzat Mona,
Fonarow Gregg C.,
GomezMesa JuanEsteban,
Heidenreich Paul,
Imamura Teruhiko,
Jankowska Ewa A.,
Januzzi James,
Khazanie Prateeti,
Kinugawa Koichiro,
Lam Carolyn S.P.,
Matsue Yuya,
Metra Marco,
Ohtani Tomohito,
Francesco Piepoli Massimo,
Ponikowski Piotr,
Rosano Giuseppe M.C.,
Sakata Yasushi,
Seferović Petar,
Starling Randall C.,
Teerlink John R.,
Vardeny Orly,
Yamamoto Kazuhiro,
Yancy Clyde,
Zhang Jian,
Zieroth Shelley
Publication year - 2021
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.2115
Subject(s) - ejection fraction , heart failure , medicine , cardiology , natriuretic peptide
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%.