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
