Heart failure is the end stage of all heart diseases. According to the process of heart failure development, it can be divided into four stages: A, B, C and D, from the high risk group of heart failure to organic heart disease and the appearance of heart failure symptoms to the refractory end stage of heart failure, thus providing a comprehensive concept from “prevention” to “treatment”. This provides a comprehensive concept from “prevention” to “treatment”. These four stages are different from the New York Heart Association’s (NYHA) cardiac function classification, and are two different concepts. Stage A is the “Pre-Heart Failure” stage, which includes people who are at high risk for heart failure, but do not currently have structural or functional abnormalities of the heart, nor do they have signs and/or symptoms of heart failure. This group includes patients with hypertension, coronary artery disease, diabetes mellitus, and other recent epidemics such as obesity and metabolic syndrome that can eventually involve the heart, as well as patients with a history of cardiotoxic drug use, alcohol abuse, rheumatic fever, or family history of cardiomyopathy. This phase should emphasize that heart failure is preventable. 60% to 80% of patients with heart failure have hypertension. According to the Framingham Heart Study, hypertension causes heart failure in 39% of men and 59% of women; and controlling hypertension reduces the risk of new heart failure by about 50%. The UKPDS trial showed that the use of ACEI and beta-blockers in diabetic patients with hypertension reduced the risk of new heart failure by 56%. Treatment should be directed at controlling risk factors and actively treating the original disease in high-risk groups: for example, actively treating hypertension, lowering blood pressure to the target level, quitting smoking and correcting dyslipidemia, regular exercise, limiting alcohol consumption, and controlling metabolic syndrome; ACEI (class IIa, level A) can be applied to those with multiple risk factors; angiotensin receptor blockers (ARB) can also be applied (class IIa, level C). Stage B is the “Pre-Clinical Heart Failure” stage. Patients start with no signs and/or symptoms of heart failure, but have developed structural heart disease, such as left ventricular hypertrophy, asymptomatic valvular heart disease, and a past history of MI. This stage corresponds to asymptomatic heart failure, or NYHA class I cardiac function. Since heart failure is a progressive lesion and myocardial remodeling can progress continuously on its own, aggressive treatment of patients in this stage is extremely important, and the key to treatment is to block or delay myocardial remodeling. Therapeutic measures: ? All phase A measures are included. ACEI, β-blockers can be used in patients with low left ventricular ejection fraction (LVEF) with or without a history of myocardial infarction (MI) (Class I, Level A). ARB (Class I, Level B) can be applied when the LVEF is low after MI and cannot tolerate ACEI.? Coronary revascularization should be performed in appropriate cases of coronary heart disease (CHD) (Class I, Level A). …Patients with valve stenosis or regurgitation with severe hemodynamic disturbances may undergo valve replacement or repair (Class I, Level B).? A buried cardiac defibrillator resuscitator (ICD ) can be used for post-MI, LVEF ≤ 30%, NYHA class I cardiac function, and expected survival time > 1 year . Other treatments: There is no evidence for the recommendation of cardiac resynchronization therapy (CRT). No application of digoxin (Class III, Level C). No need for cardiotonic agents (Class III, Level C). Calcium antagonists (CCB) with negative inotropic effects are harmful (Class III, Level C). III. Stage C is the clinical heart failure stage. The patient has underlying structural heart disease and has had or currently has signs and/or symptoms of heart failure; or currently has no signs and/or symptoms of heart failure but has been treated for it in the past. This stage includes patients with NYHA class II, III and some class IV heart function. Treatment in Stage C includes all Stage A measures and routine application of diuretics (Class I, Level A), ACEI (Class I, Level A), and beta-blockers (Class I, Level A). Digoxin (Class IIa, Level A) may be added to improve symptoms. Aldosterone receptor antagonists (Class I, Level B), ARB (Class I or Class IIa, Level A), and nitrates (Class IIb, Level C) may be used in certain selective patients. CRT (Class I, Level A) and ICD (Class I, Level A) can be applied to select suitable cases. IV. Stage D is the refractory end-stage heart failure stage. Patients have progressive structural heart disease, remain symptomatic at rest despite aggressive medical therapy, and require special interventions. For example, patients who have to be hospitalized repeatedly due to heart failure and cannot be safely discharged from the hospital; those who require long-term intravenous medication at home; those awaiting heart transplantation; those with mechanical cardiac assist devices; and some patients with NYHA class IV heart function. The prognosis for patients in this stage is extremely poor, with an average survival time of only 3.4 months. The treatment of stage D includes all the measures of stages A, B, and C. The following may be applied: heart transplantation, left ventricular assist device, intravenous positive inotropic drugs to relieve symptoms; if the renal insufficiency is severe and the edema becomes refractory, ultrafiltration or hemodialysis may be applied. Important complications such as sleep disorders, depression, anemia, renal insufficiency, etc. should be noted and managed appropriately .