From Ejection Fraction to Phenotype: Practical Application of the 2026 ESC Guidelines for the Management of Patients with Heart Failure

Bondarenko D.V.

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From Ejection Fraction to Phenotype: Practical Application of the 2026 ESC Guidelines for the Management of Patients with Heart Failure

October 14, 2026

Bondarenko D.V.

УДК: УДК 616.12-008.46

DOI: 10.32471/umj.1680-3051.281458

Keywords :

left ventricular ejection fraction,

NT-proBNP,

phenotyping

Resume

The updated 2026 European Society of Cardiology (ESC) guidelines for the management of heart failure (HF) reflect a shift from the formal assessment of ejection fraction to comprehensive clinical phenotyping and the identification of specific etiologies. This article reviews the modern diagnostic pathway for HF: ranging from clinical suspicion, assessment of natriuretic peptides, electrocardiography, and echocardiography to the use of cardiovascular magnetic resonance imaging, coronary imaging, genetic testing, scintigraphy, positron emission tomography, endomyocardial biopsy, and right heart catheterization. Particular attention is paid to the new classification of HF phenotypes and the practical significance of advanced phenotyping, illustrated by clinical cases involving a left ventricular ejection fraction of 45% and transthyretin amyloid cardiomyopathy.

References

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