HFA-PEFF scores: prognostic value in heart failure with preserved left ventricular ejection fraction

Abstract

Background/Aims: The Heart Failure Association (HFA)-PEFF score is recognized as a simple method to diagnose heart failure (HF) with preserved ejection fraction (HFpEF). This study aimed to evaluate the relationship between HFA-PEFF scores and cardiovascular outcomes in HFpEF patients.Methods: A total of 502 consecutive HFpEF patients were prospectively observed for up to 1,500 days. Cardiovascular outcomes were compared between two groups of patients, defined by their HFA-PEFF scores: those who scored 2–4 (the intermediate-score group) and those who scored 5–6 group (the high-score group). Overall, 236 cardiovascular events were observed during the follow-up period (median, 1,159 days).Results: Kaplan-Meier analysis showed that there were significant differences in composite cardiovascular events and HF-related events between the intermediate-score group and the high-score group (p = 0.003 and p < 0.001, respectively). Multivariate Cox proportional hazards analysis showed that the HFA-PEFF scores significantly predicted future HF-related events (hazard ratio, 1.66; 95% confidence interval [CI], 1.11 to 2.50; p = 0.014); receiver operating characteristic analysis confirmed this relationship (area under the curve, 0.633; 95% CI, 0.574 to 0.692; p < 0.001). The cutoff HFA-PEFF score for the identification of HF-related events was 4.5. Decision curve analysis revealed that combining the HFA-PEFF score with conventional prognostic factors improved the prediction of HF-related events.Conclusions: HFA-PEFF scores may be useful for predicting HF-related events in HFpEF patients.

Obesity-related heart failure with preserved ejection fraction: diagnostic and therapeutic challenges

“…However, the appropriate BMI cutoff value for Asian populations, who have a lower BMI than Western populations, should be investigated separately. Second, the HFA-PEFF score is determined based on three domains of heart function (functional, morphological, and biomarker domains) [8,11]. The HFA-PEFF score is based on nine echocardiographic parameters, which increases the complexity.…”

Genomic, Proteomic, and Metabolic Comparisons of Small Animal Models of Heart Failure With Preserved Ejection Fraction: A Tale of Mice, Rats, and Cats

“… 20 The HFA‐PEFF score is more complicated and evaluates natriuretic peptide levels and echocardiographic findings of cardiac function and structure. 16 Both appear to have diagnostic and prognostic value, 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 although H 2 FPEF may be better at predicting exercise intolerance. 32 Recently, the HFA‐PEFF score was used to identify 4 distinct phenogroups in “early‐HFpEF” patients of increasing severity: (1) no LV diastolic dysfunction, (2) LV diastolic dysfunction with functional LV abnormalities; (3) LV diastolic dysfunction with functional and structural LV abnormalities, and (4) LV diastolic dysfunction with functional and structural LV abnormalities and elevated B‐type natriuretic peptide.…”

Evaluation of the HFA‐PEFF Score: results from the prospective DIAST‐CHF cohort

“…The HFA‐PEFF score has been developed based on previous findings and expert opinion but was not based on calculations and prospectively performed cohorts to prove its clinical value and validity. So far, the HFA‐PEFF score has only been either retrospectively tested on small cohorts or with only a short follow‐up period 8–15 …”

“…So far, the HFA-PEFF score has only been either retrospectively tested on small cohorts or with only a short follow-up period. [8][9][10][11][12][13][14][15] An analysis with a sufficient follow-up period to assess the prognostic value has been missing. Therefore, the aim of this study is to evaluate the diagnostic value of the HFA-PEFF algorithm by assessing the predictive value of the score in a large well-defined cohort with a long follow-up period considering overall mortality symptom burden as well as functional status.…”