<div class="OutlineElement Ltr SCXW161840937 BCX0"> <p class="Paragraph SCXW161840937 BCX0" paraid="1269456457" paraeid="{95f78287-9f2c-4def-98f4-3a3dbf7863ef}{13}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW161840937 BCX0"><span class="NormalTextRun SCXW161840937 BCX0">Leading cardiology societies have published a second universal definition of heart failure that a</span><span class="NormalTextRun SCXW161840937 BCX0">dvocates for the<span> </span></span><span class="NormalTextRun SCXW161840937 BCX0">condition<span> </span></span><span class="NormalTextRun SCXW161840937 BCX0">to</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>be classified according to its clinical course and presentation, not only by ejection fraction</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>(EF)</span><span class="NormalTextRun SCXW161840937 BCX0">.</span></span><span class="EOP Selected SCXW161840937 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW161840937 BCX0"> <p class="Paragraph SCXW161840937 BCX0" paraid="2106234076" paraeid="{95f78287-9f2c-4def-98f4-3a3dbf7863ef}{15}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW161840937 BCX0"><span class="NormalTextRun SCXW161840937 BCX0">The updated framework</span><span class="NormalTextRun SCXW161840937 BCX0">, which appears in</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>the<span> </span></span></span><em><span class="NormalTextRun SCXW161840937 BCX0">Journal of the American College of Cardiology</span></em><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>and has been co-published in<span> </span></span><em><span class="NormalTextRun SCXW161840937 BCX0">Circulation, the European Heart Journal and Global Heart</span></em><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW161840937 BCX0"><span class="NormalTextRun SCXW161840937 BCX0"><em>,</em><span> </span></span><span class="NormalTextRun SCXW161840937 BCX0">highlights the need for earlier diagnosis,<span> </span></span><span class="NormalTextRun SCXW161840937 BCX0">the role<span> </span></span><span class="NormalTextRun SCXW161840937 BCX0">of biomarkers and imaging and more personalized treatment strategies across the spectrum of heart failure. </span></span><span class="EOP Selected SCXW161840937 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW161840937 BCX0"> <p class="Paragraph SCXW161840937 BCX0" paraid="967685412" paraeid="{95f78287-9f2c-4def-98f4-3a3dbf7863ef}{17}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW161840937 BCX0"><span class="NormalTextRun SCXW161840937 BCX0">“This consensus document presents the Second Universal Definition of Heart Failure, aiming to standardize terminology and facilitate a uniform approach for clinicians, researchers, health systems and policymakers</span><span class="NormalTextRun SCXW161840937 BCX0">,” wrote the<span> </span></span><span class="NormalTextRun SCXW161840937 BCX0">author</span><span class="NormalTextRun SCXW161840937 BCX0">s, led by<span> </span></span><span class="NormalTextRun SCXW161840937 BCX0">first author<span> </span></span><span class="NormalTextRun SCXW161840937 BCX0">Mary Norine Walsh, MD,<span> </span></span><span class="NormalTextRun SCXW161840937 BCX0">from</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>Ascension St. Vincent Heart Center</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>in<span> </span></span><span class="NormalTextRun SCXW161840937 BCX0">Indianapolis, Indiana.</span></span><span class="EOP Selected SCXW161840937 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW161840937 BCX0"> <p class="Paragraph SCXW161840937 BCX0" paraid="891581763" paraeid="{95f78287-9f2c-4def-98f4-3a3dbf7863ef}{19}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW161840937 BCX0"><span class="NormalTextRun SCXW161840937 BCX0">“</span><span class="NormalTextRun SCXW161840937 BCX0">In this definition, the classification of HF phenotypes moves away from rigid left ventricular ejection fraction cutoffs, instead grouping HF into reduced, preserved and improved ejection fraction categories to better reflect clinical realities.”</span></span><span class="EOP Selected SCXW161840937 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW161840937 BCX0"> <p class="Paragraph SCXW161840937 BCX0" paraid="372556473" paraeid="{95f78287-9f2c-4def-98f4-3a3dbf7863ef}{21}"><strong><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun MacChromeBold SCXW161840937 BCX0"><span class="NormalTextRun SCXW161840937 BCX0">Updated </span><span class="NormalTextRun SCXW161840937 BCX0">d</span><span class="NormalTextRun SCXW161840937 BCX0">efinition</span></span><span class="EOP Selected SCXW161840937 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW161840937 BCX0"> <p class="Paragraph SCXW161840937 BCX0" paraid="419432695" paraeid="{95f78287-9f2c-4def-98f4-3a3dbf7863ef}{23}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW161840937 BCX0"><span class="NormalTextRun SCXW161840937 BCX0">According to the authors,</span><span> </span><span class="NormalTextRun SCXW161840937 BCX0">the update was<span> </span></span><span class="NormalTextRun SCXW161840937 BCX0">required</span><span> </span><span class="NormalTextRun SCXW161840937 BCX0">to reflect changes in heart failure diagnosis,<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW161840937 BCX0">prevention</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>and treatment since the 2021 introduction of the original Universal Definition and Classification. </span></span><span class="EOP Selected SCXW161840937 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW161840937 BCX0"> <p class="Paragraph SCXW161840937 BCX0" paraid="933689652" paraeid="{95f78287-9f2c-4def-98f4-3a3dbf7863ef}{25}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW161840937 BCX0"><span class="NormalTextRun SCXW161840937 BCX0">They note</span><span class="NormalTextRun SCXW161840937 BCX0">d</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>that inconsistent definitions have impeded research, global<span> </span></span><span class="NormalTextRun SCXW161840937 BCX0">surveillance</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>and prevention efforts, particularly as heart failure prevalence continues to climb worldwide.</span></span><span class="EOP Selected SCXW161840937 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW161840937 BCX0"> <p class="Paragraph SCXW161840937 BCX0" paraid="182720885" paraeid="{95f78287-9f2c-4def-98f4-3a3dbf7863ef}{27}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW161840937 BCX0"><span class="NormalTextRun SCXW161840937 BCX0">A</span><span class="NormalTextRun SCXW161840937 BCX0">n important</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>development in the new definition<span> </span></span><span class="NormalTextRun SCXW161840937 BCX0">wa</span><span class="NormalTextRun SCXW161840937 BCX0">s the recognition that ejection fraction alone offer</span><span class="NormalTextRun SCXW161840937 BCX0">ed</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>an incomplete picture of heart failure. </span></span><span class="EOP Selected SCXW161840937 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW161840937 BCX0"> <p class="Paragraph SCXW161840937 BCX0" paraid="1346111348" paraeid="{95f78287-9f2c-4def-98f4-3a3dbf7863ef}{29}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW161840937 BCX0"><span class="NormalTextRun SCXW161840937 BCX0">While left ventricular ejection fraction continues to be used in diagnosis, treatment planning and clinical research, the authors suggest</span><span class="NormalTextRun SCXW161840937 BCX0">ed</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>that rigid thresholds can be arbitrary and may hide important variations associated with sex,<span> </span></span><span class="NormalTextRun SCXW161840937 BCX0">age</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>and ethnicity.</span></span><span class="EOP Selected SCXW161840937 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW161840937 BCX0"> <p class="Paragraph SCXW161840937 BCX0" paraid="1837508105" paraeid="{95f78287-9f2c-4def-98f4-3a3dbf7863ef}{31}"><strong><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun MacChromeBold SCXW161840937 BCX0"><span class="NormalTextRun SCXW161840937 BCX0">Underlying </span><span class="NormalTextRun SCXW161840937 BCX0">c</span><span class="NormalTextRun SCXW161840937 BCX0">auses</span></span><span class="EOP Selected SCXW161840937 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW161840937 BCX0"> <p class="Paragraph SCXW161840937 BCX0" paraid="1471521204" paraeid="{95f78287-9f2c-4def-98f4-3a3dbf7863ef}{33}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW161840937 BCX0"><span class="NormalTextRun SCXW161840937 BCX0">A key feature of the new framework<span> </span></span><span class="NormalTextRun SCXW161840937 BCX0">wa</span><span class="NormalTextRun SCXW161840937 BCX0">s its emphasis on<span> </span></span><span class="NormalTextRun SCXW161840937 BCX0">identifying</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>what dr</span><span class="NormalTextRun SCXW161840937 BCX0">o</span><span class="NormalTextRun SCXW161840937 BCX0">ve heart failure. It move</span><span class="NormalTextRun SCXW161840937 BCX0">d</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>away from simple distinctions such as ischemic versus nonischemic cardiomyopathy and instead present</span><span class="NormalTextRun SCXW161840937 BCX0">ed</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>a more comprehensive list of causes</span><span class="NormalTextRun SCXW161840937 BCX0">.</span></span><span class="EOP Selected SCXW161840937 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW161840937 BCX0"> <p class="Paragraph SCXW161840937 BCX0" paraid="2102407268" paraeid="{95f78287-9f2c-4def-98f4-3a3dbf7863ef}{35}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW161840937 BCX0"><span class="NormalTextRun SCXW161840937 BCX0">These<span> </span></span><span class="NormalTextRun SCXW161840937 BCX0">includ</span><span class="NormalTextRun SCXW161840937 BCX0">ed</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>hypertensive, valvular, arrhythmia-related, infiltrative, infective, inflammatory, toxic, heritable, metabolic, pregnancy-related, pulmonary/right-sided and high-output cardiomyopathies.</span></span><span class="EOP Selected SCXW161840937 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW161840937 BCX0"> <p class="Paragraph SCXW161840937 BCX0" paraid="262937596" paraeid="{95f78287-9f2c-4def-98f4-3a3dbf7863ef}{37}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW161840937 BCX0"><span class="NormalTextRun SCXW161840937 BCX0">A more comprehensive approach could support more targeted treatment. For instance, patients with cardiac amyloidosis contributing to heart failure may<span> </span></span><span class="NormalTextRun SCXW161840937 BCX0">benefit</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>from therapies that specifically target the disease, alongside conventional treatments.</span></span><span class="EOP Selected SCXW161840937 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW161840937 BCX0"> <p class="Paragraph SCXW161840937 BCX0" paraid="571620830" paraeid="{95f78287-9f2c-4def-98f4-3a3dbf7863ef}{39}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW161840937 BCX0"><span class="NormalTextRun SCXW161840937 BCX0">The document also describe</span><span class="NormalTextRun SCXW161840937 BCX0">d</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>heart failure as a condition that can progress along different pathways, including improvement,<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW161840937 BCX0">remission</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>and recovery. </span></span><span class="EOP Selected SCXW161840937 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW161840937 BCX0"> <p class="Paragraph SCXW161840937 BCX0" paraid="1907245096" paraeid="{95f78287-9f2c-4def-98f4-3a3dbf7863ef}{41}"><strong><span class="NormalTextRun SCXW161840937 BCX0">Ongoing risks</span><span class="EOP Selected SCXW161840937 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW161840937 BCX0"> <p class="Paragraph SCXW161840937 BCX0" paraid="1773062497" paraeid="{95f78287-9f2c-4def-98f4-3a3dbf7863ef}{43}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW161840937 BCX0"><span class="NormalTextRun SCXW161840937 BCX0">However, the authors stress</span><span class="NormalTextRun SCXW161840937 BCX0">ed</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>that improved ejection</span><span> </span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW161840937 BCX0">fraction</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>d</span><span class="NormalTextRun SCXW161840937 BCX0">id</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>not necessarily mean the condition ha</span><span class="NormalTextRun SCXW161840937 BCX0">d</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>been resolved. Patients may still<span> </span></span><span class="NormalTextRun SCXW161840937 BCX0">exhibit</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>structural abnormalities, abnormal<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW161840937 BCX0">biomarkers</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>or face a risk of relapse, making continued therapy and<span> </span></span><span class="NormalTextRun SCXW161840937 BCX0">monitoring</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>essential.</span></span><span class="EOP Selected SCXW161840937 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW161840937 BCX0"> <p class="Paragraph SCXW161840937 BCX0" paraid="1040119547" paraeid="{95f78287-9f2c-4def-98f4-3a3dbf7863ef}{45}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW161840937 BCX0"><span class="NormalTextRun SCXW161840937 BCX0">It also highlight</span><span class="NormalTextRun SCXW161840937 BCX0">ed</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>worsening and decompensated heart failure, as well as conditions that c</span><span class="NormalTextRun SCXW161840937 BCX0">ould</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>resemble heart failure, such as chronic kidney disease, obesity, deconditioning, pregnancy-related<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW161840937 BCX0">symptoms</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>and coronary artery disease.</span></span><span class="EOP Selected SCXW161840937 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW161840937 BCX0"> <p class="Paragraph SCXW161840937 BCX0" paraid="1598980082" paraeid="{95f78287-9f2c-4def-98f4-3a3dbf7863ef}{48}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW161840937 BCX0"><span class="NormalTextRun SCXW161840937 BCX0">By aligning terminology and classification, the authors suggest</span><span class="NormalTextRun SCXW161840937 BCX0">ed</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>the framework could enable earlier detection, enhance prevention, improve research<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW161840937 BCX0">consistency</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>and support more<span> </span></span><span class="NormalTextRun SCXW161840937 BCX0">equitable</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>care globally.</span></span><span class="EOP Selected SCXW161840937 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW161840937 BCX0"> <p class="Paragraph SCXW161840937 BCX0" paraid="1597356532" paraeid="{95f78287-9f2c-4def-98f4-3a3dbf7863ef}{50}"><strong><span class="NormalTextRun SCXW161840937 BCX0">Source:</span><span class="EOP Selected SCXW161840937 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW161840937 BCX0"> <p class="Paragraph SCXW161840937 BCX0" paraid="716391590" paraeid="{95f78287-9f2c-4def-98f4-3a3dbf7863ef}{52}"><span class="NormalTextRun SCXW161840937 BCX0">Walsh MN, Kober L, Sliwa K, et al. AHA/ACC/ESC/WHF Expert Consensus Document: Second Universal Definition of Heart Failure (2026).<span> </span></span><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW161840937 BCX0"><em><span class="NormalTextRun SCXW161840937 BCX0">J Am Coll </span><span class="NormalTextRun SpellingErrorV2Themed SCXW161840937 BCX0">Cardiol</span></em><span class="NormalTextRun SCXW161840937 BCX0">.</span></span><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW161840937 BCX0"><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>2026</span><span class="NormalTextRun SCXW161840937 BCX0"><span> </span>June 29 (Article in Press).</span></span><span class="EOP Selected SCXW161840937 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></p> </div> <div class="OutlineElement Ltr SCXW161840937 BCX0"> <p class="Paragraph SCXW161840937 BCX0" lang="EN-US" paraid="657026014" paraeid="{cfbf5447-a1f5-43f6-a9bb-a7a985a169a4}{109}"><strong><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun MacChromeBold SCXW161840937 BCX0"><span class="NormalTextRun SCXW161840937 BCX0">Image Credit: </span><span class="NormalTextRun SpellingErrorV2Themed SCXW161840937 BCX0">iushakovsky</span><span class="NormalTextRun SCXW161840937 BCX0"> – stock.adobe.com</span></span><span class="EOP Selected SCXW161840937 BCX0" data-ccp-props="{"335551550":6,"335551620":6}"> </span></strong></p> </div>