According to the joined AHA/ACC committee, the progressive nature of left ventricular dysfunction and HF can be appropriately accounted for by considering 4 stages in the evolution of the disease.
Stage A This stage identifies patients who are at high risk for developing HF, since they have one or more risk factors, but they have no structural disorder of the heart;
Stage B This stage refers to patients who, despite a structural disorder of the heart, have never developed symptoms of HF;
Stage C This stage denotes patients with past or current symptoms of HF associated with underlying structural heart disease;
Stage D This stage designates patients with end-stage disease who require specialized treatment strategies such as mechanical circulatory support, continuous inotropic infusions, cardiac transplantation, or hospice care (see Table 1).