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ACC AHA Heart Failure Guidelines 2022 Update

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3 Table 3. Stages of HF Stages Definition and Criteria Stage A: At Risk for HF At risk for HF but without symptoms, structural heart disease, or cardiac biomarkers of stretch or injury (e.g., patients with hypertension, atherosclerotic CVD, diabetes, metabolic syndrome and obesity, exposure to cardiotoxic agents, genetic variant for cardiomyopathy, or positive family history of cardiomyopathy). Stage B: Pre-HF No symptoms or signs of HF and evidence of 1 of the following : Structural heart disease* • Reduced left or right ventricular systolic function » Reduced ejection fraction, reduced strain • Ventricular hypertrophy • Chamber enlargement • Wall motion abnormalities • Valvular heart disease Evidence for increased filling pressures* • By invasive hemodynamic measurements • By noninvasive imaging suggesting elevated filling pressures (e.g., Doppler echocardiography) Patients with risk factors and • Increased levels of BNPs* or • Persistently elevated cardiac troponin in the absence of competing diagnoses resulting in such biomarker elevations such as acute coronary syndrome, CKD, pulmonary embolus, or myopericarditis Stage C: Symptomatic HF Structural heart disease with current or previous symptoms of HF. Stage D: Advanced HF Marked HF symptoms that interfere with daily life and with recurrent hospitalizations despite attempts to optimize GDMT. * Abciximab may not be readily available to clinicians in the U.S. Note: The numbering of the following tables differs from that of the Clinical Practice Guideline. Colors in tables and figures correspond to Class of Recommendations and Level of Evidence tables on pages 78–79. Assessment

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