2026 Second Universal Definition of Heart Failure

The Second Universal Definition of Heart Failure (HF) introduces a standardized global framework that updates how HF is defined, classified, prevented, and managed, with the goal of improving patient care and cardiovascular health worldwide. Recognizing the growing burden of HF and the limitations of previous definitions, international cardiac societies and foundations refined the concept of HF and its precursor stage, stage B (pre-HF), to better identify individuals at risk before symptoms develop. The new definition moves away from rigid left ventricular ejection fraction thresholds and instead classifies HF into reduced, preserved, and improved ejection fraction categories, reflecting clinical realities more accurately. It also proposes a universal classification of HF causes and emphasizes that HF is a dynamic condition, with patients potentially experiencing improvement, remission, or recovery over time. In addition, the document highlights the important roles of comorbidities, healthcare access, social determinants of health, and geographic disparities in shaping HF risk and outcomes. By establishing consistent terminology and a comprehensive classification system, this updated consensus aims to strengthen HF prevention, facilitate earlier diagnosis, improve treatment strategies, and support research and public health efforts across the globe. Source: https://www.jacc.org/