Introduction
This is the updated clinical guideline on the diagnosis and treatment of heart failure, based on the recommendations of the European Society of Cardiology (ESC) and the American Heart Association (AHA/ACC) in 2025. The full document can be downloaded below.
Classification of Heart Failure
Heart failure is classified into 3 groups: HFrEF (EF ≤ 40%), HFmrEF (EF 41-49%), and HFpEF (EF ≥ 50%). Each group has different treatment strategies.
GDMT (Guideline-Directed Medical Therapy) Regimen
Four pillars of HFrEF treatment: (1) ARNI/ACEi/ARB, (2) Beta-blocker, (3) MRA, (4) SGLT2 inhibitor. Class I recommendation for all HFrEF patients without contraindications.
Diagnostic Criteria
Diagnosis of heart failure is based on clinical symptoms (dyspnea, edema, fatigue), NT-proBNP (≥ 125 pg/mL), and echocardiography (assessment of EF, cardiac structure). Cardiac MRI is recommended when echocardiography is inconclusive.
Download full document
📥 The full clinical guideline document (PDF, 45 pages) is available for download for Premium members. Includes: classification tables, treatment regimens, diagnostic algorithms, and drug lists.
