The H2FPEF score enables discrimination of heart failure with preserved ejection fraction (HFpEF) from non-cardiac causes of dyspnea and can assist in determination of the need for further diagnostic testing in the evaluation of patients with unexplained exertional dyspnea. This according to a study that included consecutive patients with unexplained dyspnea referred for invasive hemodynamic exercise testing. Diagnosis of HFpEF (case) or non-cardiac dyspnea (control) was determined by invasive hemodynamic exercise testing. A scoring system was developed and then validated in a separate test cohort. Researchers found:
- The derivation cohort included 414 consecutive patients (267 HFpEF and 147 controls, HFpEF prevalence 64%).
- The test cohort included 100 consecutive patients (61 HFpEF, prevalence 61%).
- A weighted score based on 6 variables (obesity, atrial fibrillation, age >60 years, treatment with ≥2 antihypertensives, echocardiographic E/e’ ratio >9, and echocardiographic pulmonary artery systolic pressure >35 mmHg) was used to create a composite score (H2FPEF score) ranging from 0-9.
- The odds of HFpEF doubled for each 1-unit score increase.
- The H2FPEF score was superior to a currently-used algorithm based upon expert consensus.
Reddy YNV, Carter RE, Obokata M, Redfield MM, Borlaug BA. A simple, evidence-based approach to help guide diagnosis of heart failure with preserved ejection fraction. [Published online ahead of print May 23, 2018]. Circulation. doi:10.1161/CIRCULATIONAHA.118.034646.
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