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FAQ: Second Universal Definition of Heart Failure
The Second Universal Definition of Heart Failure, issued by leading cardiovascular organizations, updates the 2021 definition to improve early detection, individualized risk reduction, and global consistency. It introduces a universal classification of heart failure causes and shifts from rigid LVEF thresholds to actionable categories, aiming to enhance prevention, diagnosis, and care worldwide.
It is an international expert consensus document that refines and updates how heart failure is identified and classified, aiming to improve prevention, diagnosis, and management globally.
Inconsistencies in how heart failure is defined have limited progress in research and treatment. The update provides a clearer, more consistent framework to help clinicians identify risk earlier and guide more personalized treatment approaches.
It was developed by leading cardiovascular organizations including the American Heart Association, American College of Cardiology, European Society of Cardiology, and World Heart Federation, in collaboration with the Heart Failure Society of America, Heart Failure Association of the ESC, and Japanese Heart Failure Society.
Key changes include a universal classification system for heart failure causes and a shift away from rigid left ventricular ejection fraction (LVEF) thresholds to clinically actionable categories that account for differences by sex, age, and ethnicity.
By standardizing terminology and classification, it helps clinicians better identify underlying conditions, guide targeted care, and improve consistency in clinical trials and registries, ultimately enhancing patient outcomes.
It was published on June 29, 2026, simultaneously in Circulation, JACC, European Heart Journal, and Global Heart.
It is intended for global use, with explicit acknowledgment of geographic variation in heart failure risk and outcomes.
It allows standardized reporting of data from trials and registries, helping clinicians identify underlying conditions and guide targeted care beyond standard treatment.
Instead of strict cutoff values, it offers clinically actionable categories that consider differences by sex, age, and ethnicity, enabling more personalized assessment.