AHA/ACC/ESC/WHF Expert Consensus Document in Collaboration with HFSA, HFA and JHFS: Second Universal Definition of Heart Failure (2026)
Updated: June 29, 2026
- In response to the rising global prevalence of heart failure (HF) and limitations in research, surveillance, and prevention, in 2021 multiple cardiac societies convened to issue the First Universal Definition of Heart Failure, establishing uniform terminology, including a designated Stage B (pre-HF) to identify at-risk individuals.
- The identification of more diverse phenotypes of HF, need for accurate identification and diagnosis specific to HF phenotype, and the continued disparities in care underscore the need for the updated Second Universal Definition of Heart Failure from the American Heart Association (AHA), American College of Cardiology (ACC), European Society of Cardiology (ESC) and World Heart Federation (WHF) in collaboration with the Heart Failure Society of America (HFSA), the Heart Failure Association (HFA) of the European Society of Cardiology, and the Japanese Heart Failure Society (JHFS).
- Building on the first definition, the second definition refines HF staging with sharper stage criteria, emphasizing early detection and individualized risk reduction and introduces the universal classification of HF causes, with explicit acknowledgment of geographic variation in etiology.
Recommended Reading
- Risk-Based Primary Prevention of Heart Failure
- Implementation Science to Achieve Equity in Heart Failure Care
- Complementary and Alternative Medicines in the Management of Heart Failure
- Addressing Social Determinants of Health in the Care of Patients With Heart Failure
- Contributory Risk and Management of Comorbidities of Hypertension, Obesity, Diabetes Mellitus, Hyperlipidemia, and Metabolic Syndrome in Chronic Heart Failure
- 2022 Guideline for the Management of Heart Failure