Table 5.

Stages of heart failure according to the 2022 ACC/AHA/HFSA guidelines.

Stages of HF	Definition and Criteria
Stage A At risk of HF	People who are at risk for HF, but without symptoms, structural or functional heart disease, or elevated NPs. Risk factors include: Hypertension Atherosclerotic CVD DM Obesity and metabolic syndrome Exposure to cardiotoxic agents Genetic variants for cardiomyopathy and 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 of 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 ACS, 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.

HF, heart failure; NPs, natriuretic peptides; DM, diabetes mellitus; CVD, cardiovascular disease; ACS, acute coronary syndrome; CKD, chronic kidney disease; BNP, B-type natriuretic peptide; GDMT, guideline-directed medical therapy [9].