Figure 1.

The clinical behaviour of HF syndrome and the main features of WHF. In the left side of the figure, HF is represented as a progressive disease. In the right side of the figure, the main features of WHF are represented. A distinction between the conceptual and the clinical definition is made. Subclinical worsening is often underdiagnosed in clinical practice and its identification may prevent adverse outcomes. The improvement of WHF management should involve the creation of a personalized, patient-tailored approach. HF: heart failure; WHF: worsening heart failure; LVAD: left ventricular assist device; LVEF: left ventricular ejection fraction; OMT: optimized medical therapy; NT proBNP: N-terminal pro B-type natriuretic peptide; CIEDs: cardiac implantable electronic devices; WHF: worsening heart failure.