Universal Definition and Classification of Heart Failure

The Heart Failure Society of America (HFSA), the Heart Failure Association of the European Society of Cardiology (HFA-ESC) and the Japanese Heart Failure Society (JHFS) announced a new Universal Definition and Classification of Heart Failure, which will standardize language and practices around the definition and classification of heart failure (HF).

Thus far, the definitions of HF have lacked standardization among clinicians, investigators, administrators, health care services, institutions, legislators and payers, as well as patients and caregivers. The new Universal Definition and Classification of Heart Failureprovides a definition that is clinically relevant and simple but conceptually comprehensive. It also offers the ability to sub-classify HF within ejection fraction (EF) groups and provides revised classification of stages of HF. The new definition and classification can be used in a standardized fashion across scientific societies and guidelines, employed by clinicians, used in research studies and incorporated into discussions with patients and caregivers.

“The release of the Universal Definition and Classification of Heart Failure marks an exciting time in the field of heart failure as we’ve been burdened with different descriptors that often cause discordance in the HF scientific community, from providers to legislators and everything in between. Also, some of the staging terminologies we had used were not clear for our patients, and classifications for EF needed further clarification for the health care professionals,” said Biykem Bozkurt, MD, FHFSA, Immediate Past President of the Heart Failure Society of America. “A standard heart failure definition that’s accepted by our three societies and endorsed by many others, and classifications that are understandable by patients and clinicians will change the future of HF care, allowing us to focus on prevention strategies for patients at-risk for heart failure or in pre-heart failure stages, in addition to diagnosis and treatment of patients with heart failure or advanced heart failure; and implement evidence based strategies in a standardized manner across continents and different societies.”

The Universal Definition and Classification of Heart Failure has been jointly published by the Journal of Cardiac Failure, the official journal of the HFSA and the JHFS, and the European Journal of Heart Failure, the official journal of the HFA-ESC.

The three professional societies gather annually at the Trilateral International Heart Failure Consensus Conference (TIHF) to address and develop a joint publication on significant topics of interest in the heart failure. In 2020, HFSA led the TIHF on the topic of the universal definition and classification of heart failure. HFSA Immediate Past President Dr. Bozkurt served as Chair of the TIHF in 2020. Dr. Bozkurt was joined by co-chairs Professor Andrew Coats, 2020-2022 President of HFA-ESC, and Hiroyuki Tsutsui, President of the JHFS.

“The purpose of the TIHF is to tackle critical issues facing the field of heart failure,” said Coats. “I'm sure I speak for the leaders of HFSA and JHFS when I say HFA-ESC leaders are thrilled that we used our time together in 2020 to focus on a global consensus of the definition and classification of heart failure, which will certainly unite all those who are working to reduce the burden of heart failure around the world.”

In addition to being developed by the HFSA, ESC, and JHFS, the Universal Definition and Classification of Heart Failure has been endorsed by a number of professional societies in the cardiology space including: The Cardiac Society of Australia and New Zealand; the Chinese Heart Failure Association; the Canadian Heart Failure Society; and the Heart Failure Association of India.

“The additional support from societies beyond JHFS, HFSA, and HFA-ESC is incredible and serves to support the definition and classification on an even larger scale,” said Tsutsui. “We hope that this paper, supporting editorials and accompanying materials will serve our field and change the future of heart failure care.”

HFSA has developed a Pocket Guide and a Slide Deck to supplement the publication. A webinar, episode of the Heart Failure Beat provider podcast, and supporting editorials are coming soon.

About the Heart Failure Society of America

The Heart Failure Society of America, Inc. (HFSA) represents the first organized effort by heart failure experts from the Americas to provide a forum for all those interested in heart function, heart failure, and congestive heart failure (CHF) research and patient care. The mission of HFSA is to provide a platform to improve and expand heart failure care through collaboration, education, innovation, research, and advocacy. HFSA members include physicians, scientists, nurses, nurse practitioners, pharmacists, trainees, other healthcare workers and patients. For more information, visit hfsa.org.

About the Heart Failure Association of the European Society of Cardiology

As the world's largest heart failure association, the Heart Failure Association of the ESC prioritizes patient management and awareness of heart failure as a global health problem. HFA-ESC's mission is to improve quality of life and longevity through better prevention, diagnosis and treatment of heart failure, including the establishment of networks for its management, education and research. Learn more online.

About the Japanese Heart Failure Society

In response to the increased interest in heart failure, based on the basic studies on its mechanisms and clinical trials, the Japanese Heart Failure Society (JHFS) was established in 1996. The first General and Scientific Meeting of the JHFS was held in October 1997 at the Kyoto International Conference Center. The number of members increased from 900 to approximately 4000 in 2020. The vision of JHFS is to enrich the happy life of the patients and their families through investigating the basic pathophysiology of heart failure, and developing the effective and efficient diagnosis, prevention and treatment strategies.

About the Journal of Cardiac Failure

Launched in 1994 and a joint endeavor by the Heart Failure Society of America and the Japanese Heart Failure Society, the Journal of Cardiac Failure publishes peer-reviewed manuscripts of interest to clinicians and researchers in the field of heart failure and related disciplines. These include original communications of scientific importance and review articles involving clinical research, health services and outcomes research, animal studies, and bench research with potential clinical applications to heart failure. The Journal also publishes manuscripts that report the design of ongoing clinical trials and editorial perspectives that comment on new developments pertinent to the field of heart failure or manuscripts published in other journals. Visit the JCF online.

About the European Journal of Heart Failure

The European Journal of Heart Failure (EJHF) the journal of the Heart Failure Association of the European Society of Cardiology, is dedicated to the advancement of knowledge in the field of heart failure management. The journal publishes reviews and editorials to improve the understanding, prevention, investigation and treatment of heart failure. Molecular and cellular biology, pathology, physiology, electrophysiology, pharmacology, as well as clinical, social and population sciences all form part of the discipline. Visit EJHF online.

References

1 Bozkurt B, Coats A, Tsutsui H, et al. 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 Consensus Conference. European Journal of Heart Failure. (2021) 0, 0–0 doi:10.1002/ejhf.2115