Evaluation and management of recent onsetcardiomyopathy in the current era of heartfailure therapeutics: a clinical consensusstatement of the Heart Failure Associationof the ESC

Recent-onset cardiomyopathy represents a clinically dynamic and potentially reversible clinical framework of non-ischaemic
cardiomyopathy, characterized by high variability in left ventricular (LV) function and arrhythmic risk. This clinical consensus
statement provides a structured diagnostic and therapeutic approach based on two prognostic axes: the potential for LV reverse remodelling (LVRR) and the risk of sudden cardiac death (SCD). We operationalize four trajectories in the LV evolution, ranging from recovered LV ejection fraction (LVEF) to persistently reduced LVEF. Multimodal stratification including
echocardiography, cardiac magnetic resonance, genetic profiling, biomarkers, and early treatment response allows tailored decision-making on pharmacological and device-based therapies. We propose a unified management algorithm emphasizing early
initiation of guideline-directed medical therapy, structured reassessment at 3 and 6 months, and individualized consideration of
defibrillators, resynchronization therapy, arrhythmia ablation, transcatheter valve leaflet edge-to-edge repair, and advanced
heart failure assessment. This document aims to support clinicians in risk stratification and timely management or referrals.