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Classify

Which HF stage, which phenotype, and how each of the four 2026 documents names the same patient. Stages follow the Second Universal Definition, with KDIGO's addition that CKD belongs in stage A.

The same values as in the patient editor in the header and on the other pages: change one here and it changes there.

Sex

Calculated 84 (CKD-EPI 2021)

NYHA class

Kidney stage: G2 (eGFR 60–89).

0ABCDStage C: symptomatic HF

UACR is not an input elsewhere on this site; tick if known.

From the patient (NYHA 2).

See the Advanced HF page for the full ESC definition.

Stage C: symptomatic HF

Current or prior symptoms or signs caused by a structural or functional cardiac abnormality, corroborated by natriuretic peptides, objective congestion or haemodynamic measurement. Once established, the diagnosis is generally permanent.

Why: Current or prior symptoms or signs of HF; the diagnosis is generally permanent once established.

DocumentNames this patientNote
ESC 2026HFrEF–
Second Universal Definition 2026HF with reduced EFan LVEF below 50% is unlikely to be normal; the document avoids fixed cut-offs
AHA/ACC/HFSA 2022HFrEF–
ACC 2026 HFpEF pathwaydoes not apply (EF <50%)–
KDIGO 2026eGFR ≥60Medical management is laid out by HFrEF/HFpEF across eGFR bands; CKD counts as HF stage A.
ESC 2026

Two phenotypes: HFrEF (LVEF <50% with symptoms or signs) and HFpEF (LVEF ≥50% with symptoms or signs and objective structural or functional abnormality supported by natriuretic peptides). HFmrEF was eliminated.

Second Universal Definition 2026

Moves away from fixed LVEF cut-offs to three actionable groups: HF with reduced EF, HFpEF, and HF with improved EF. The lower limit of normal LVEF is about 53% in women and 52% in men, so an LVEF below 50% is unlikely to be normal.

AHA/ACC/HFSA 2022

Four groups by LVEF: HFrEF ≤40%; HFimpEF (previous LVEF ≤40% with a follow-up >40%); HFmrEF 41–49% with evidence of raised filling pressures; HFpEF ≥50% with evidence of raised filling pressures.

KDIGO 2026

The conference frames medical management by HFrEF/HFpEF across eGFR bands (≥60, 30–59, 15–29, <15), with CKD itself counted as HF stage A.

Enter a prior lowest LVEF to assess improvement.

Improvement, remission and recovery

Improvement: LVEF better despite ongoing abnormalities. Remission: normalized LVEF with minimal symptoms and stable biomarkers, still vulnerable to relapse. Recovery: sustained normalization of structure, function, biomarkers and symptoms over extended follow-up; reached by a minority. LVEF improvement alone does not signify resolution.