Societies collaborate to develop universal heart failure definition

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A global collaboration between international heart failure bodies seeks to standardise the language and practices around the definition and classification of heart failure around the globe.

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) have this week announced a new Universal Definition and Classification of Heart Failure, which will it is hoped will align understanding of heart failure among the organisations’ members.

To date, definitions of heart failure have lacked standardisation among clinicians, investigators, administrators, healthcare services, institutions, legislators and payers, as well as patients and caregivers, the organisations claim.

It is hoped that the new Universal Definition and Classification of Heart Failure will provide a definition that is clinically relevant and simple but conceptually comprehensive. It also offers the ability to sub-classify heart failure within ejection fraction (EF) groups and provides revised classification of stages of heart failure.

The new definition and classification can be used in a standardised fashion across scientific societies and guidelines, employed by clinicians, used in research studies and incorporated into discussions with patients and caregivers, the organisations add.

“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 heart failure 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 healthcare professionals,” said Biykem Bozkurt, Immediate Past President of the Heart Failure Society of America. “A standard heart failure definition that is accepted by our three societies and endorsed by many others, and classifications that are understandable by patients and clinicians will change the future of heart failure 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 standardised 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 Bozkurt served as Chair of the TIHF in 2020. Bozkurt was joined by co-chairs 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 am 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.”


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