The 2026 European Society of Cardiology (ESC) Guidelinеs for the management of heart failure (HF) introduce several important changes [1]. First, they return to two types based on left ventricular ejection fraction (LVEF): HF with reduced ejection fraction (HFrEF; LVEF< 50%) and HF with preserved ejection fraction (HFpEF; LVEF≥50%), while the category of mildly reduced ejection fraction is no longer used. Second, the define decompensated HF, a term that replaces acute HF and better reflects the many patients whose condition deteriorates gradually rather than suddenly.
