@article{3195333,
    title = "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",
    author = "Bozkurt, Biykem and Coats, Andrew J. S. and Tsutsui, Hiroyuki and and Abdelhamid, Ca Magdy and Adamopoulos, Stamatis and Albert, Nancy and and Anker, Stefan D. and Atherton, John and Boehm, Michael and Butler, Javed and and Drazner, Mark H. and Felker, G. Michael and Filippatos, Gerasimos and and Fiuzat, Mona and Fonarow, Gregg C. and Gomez-Mesa, Juan-Esteban and and Heidenreich, Paul and Imamura, Teruhiko and Jankowska, Ewa A. and and Januzzi, James and Khazanie, Prateeti and Kinugawa, Koichiro and Lam, and Carolyn S. P. and Matsue, Yuya and Metra, Marco and Ohtani, Tomohito and and Piepoli, Massimo Francesco and Ponikowski, Piotr and Rosano, Giuseppe M. and C. and Sakata, Yasushi and Starling, Randall C. and Teerlink, John R. and and Vardeny, Orly and Yamamoto, Kazuhiro and Yancy, Clyde and Zhang, and Jian and Zieroth, Shelley",
    journal = "European Journal of Heart Failure",
    year = "2021",
    volume = "23",
    number = "3",
    pages = "352-380",
    publisher = "Wiley",
    doi = "10.1002/ejhf.2115",
    keywords = "Heart failure; Cardiomyopathy; HFrEF; HFpEF; HFmrEF; Stages of heart
failure; Definition of heart failure",
    abstract = "In this document, we propose a universal definition of heart failure
(HF) as a clinical syndrome with symptoms and/or signs caused by a
structural and/or functional cardiac abnormality and corroborated by
elevated natriuretic peptide levels and/or objective evidence of
pulmonary or systemic congestion. We also propose revised stages of HF
as: At risk for HF (Stage A), Pre-HF (Stage B), Symptomatic HF (Stage C)
and Advanced HF (Stage D). Finally, we propose a new and revised
classification of HF according to left ventricular ejection fraction
(LVEF). This includes HF with reduced ejection fraction (HFrEF):
symptomatic HF with LVEF <= 40%; HF with mildly reduced ejection
fraction (HFmrEF): symptomatic HF with LVEF 41-49%; HF with preserved
ejection fraction (HFpEF): symptomatic HF with LVEF >= 50%; and HF with
improved ejection fraction (HFimpEF): symptomatic HF with a baseline
LVEF <= 40%, a >= 10 point increase from baseline LVEF, and a second
measurement of LVEF > 40%."
}