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Review
. 2022 Jun;45 Suppl 1(Suppl 1):S2-S12.
doi: 10.1002/clc.23842.

Clinical implications of the universal definition for the prevention and treatment of heart failure

Chanchal Chandramouli  1   2 , Simon Stewart  3   4   5 , Wael Almahmeed  6   7 , Carolyn Su Ping Lam  1   2   8
Affiliations
Review

Clinical implications of the universal definition for the prevention and treatment of heart failure

Chanchal Chandramouli et al. Clin Cardiol. 2022 Jun.

Abstract

The diagnosis of heart failure (HF) primarily relies on signs and symptoms that are neither sensitive nor specific. This impedes timely diagnosis and delays effective therapies or interventions, despite the availability of several evidence-based treatments for HF. Through monumental collaborative efforts from representatives of HF societies worldwide, the universal definition of HF was published in 2021, to provide the necessary standardized framework required for clinical management, clinical trials, and research. This review elaborates the key concepts of the new universal definition of HF, highlighting the key merits and potential avenues, which can be nuanced further in future iterations. We also discuss the key implications of the universal definition document from the perspectives of various stakeholders within the healthcare framework, including patients, care providers, system/payers and policymakers.

Keywords: HFpEF; HFrEF; NT-proBNP; clinical syndrome; stakeholders; symptoms and signs; universal definition of heart failure.

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Conflict of interest statement

Chanchal Chandramouli reports philanthropic research support from Lee Foundation Singapore and has received consultancy or speaker fees from Us2.ai, Boehringer Ingelheim, and Sanofi Aventis. Simon Stewart is supported by the NHMRC of Australia (GNT 1135894); has received speaking fees or honoraria from Edwards Lifesciences and Novartis; has received consultancy fees from Edwards Lifesciences (UK and Australia) and Novartis Australia; reports participation on a data safety monitoring board or advisory board at Edwards Lifesciences. Carolyn Su Ping Lam is supported by a Clinician Scientist Award from the National Medical Research Council of Singapore; has received research support from AstraZeneca, Bayer, Boston Scientific and Roche Diagnostics; has served as a consultant or on the Advisory Board/Steering Committee/Executive Committee for Actelion, Amgen, Applied Therapeutics, AstraZeneca, Bayer, Boehringer Ingelheim, Boston Scientific, Cytokinetics, Darma Inc., Us2.ai, Janssen Research & Development LLC, Medscape, Merck, Novartis, Novo Nordisk, Radcliffe Group Ltd., Roche Diagnostics, Sanofi, and WebMD Global LLC; and serves as cofounder and nonexecutive director of Us2.ai. Wael Almahmeed has nothing to declare.

Figures

Figure 1
Figure 1
Evolution of heart failure definitions.
Figure 2
Figure 2
Key concepts of a universal definition of HF. DM, diabetes mellitus; EF, ejection fraction; GDMT, guideline‐directed medical therapy; HF, heart failure; HT, hypertension; LVEF, left ventricular ejection fraction.
Figure 3
Figure 3
Clinical implications for key stakeholders.
See this image and copyright information in PMC

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