Dataset Information

Identification of Patients with Preclinical Heart Failure with preserved Ejection Fraction Using the H₂FPEF Score.

ABSTRACT: Heart failure with preserved ejection fraction (HFpEF) is a common disorder with few effective treatments. There is currently no evidence-based method to identify preclinical HFpEF. The H₂FPEF score is a validated instrument to identify patients with overt HFpEF. Here we show the H₂FPEF score can identify individuals with preclinical HFpEF. Among individuals where heart failure was excluded (n=160), increasing H₂FPEF score was shown to be associated with greater left atrial dilation, left ventricular hypertrophy, and more severe diastolic dysfunction. Patients with increasing H₂FPEF score displayed higher pulmonary artery pressures, higher left heart filling pressures, lower cardiac index, and more severely impaired aerobic capacity during exercise. In summary, we show that among adults without heart failure, higher H₂FPEF score is associated with subclinical abnormalities that resemble those observed in HFpEF. These findings broaden the external validity of the H₂FPEF score and suggest that this instrument may help identify patients positioned to benefit from preventive interventions.

SUBMITTER: Koepp KE

PROVIDER: S-EPMC9164289 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

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Identification of Patients with Preclinical Heart Failure with preserved Ejection Fraction Using the H2FPEF Score.

Koepp Katlyn E KE Reddy Yogesh N V YNV Obokata Masaru M Sorimachi Hidemi H Verbrugge Frederik H FH Jain C Charles CC Egbe Alexander C AC Redfield Margaret M MM Olson Thomas P TP Borlaug Barry A BA

Nature cardiovascular research 20220112 1

Heart failure with preserved ejection fraction (HFpEF) is a common disorder with few effective treatments. There is currently no evidence-based method to identify preclinical HFpEF. The H2FPEF score is a validated instrument to identify patients with overt HFpEF. Here we show the H2FPEF score can identify individuals with preclinical HFpEF. Among individuals where heart failure was excluded (n=160), increasing H2FPEF score was shown to be associated with greater ...[more]

PMID: 35669933

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Project description:BackgroundThe H2FPEF score, a convenient tool developed for diagnosing heart failure with preserved ejection fraction (HFpEF), exhibited useful prognostic utility in HFpEF. However, the applicability and the prognostic value of the H2FPEF score in Chinese HFpEF patients have yet to be fully confirmed. The study aimed to evaluate the effect of modified H2FPEF score on the prognosis of Chinese HFpEF patients.MethodsIn this retrospective study, we calculated the H2FPEF scores by body mass index (BMI) ≥ 25 kg/m2 and 30 kg/m2 respectively, for 497 consecutive HFpEF patients in China. Subjects were divided into low- (0 - 3 points), intermediate- (4 - 6 points), and high-score (7 - 9 points) groups. The primary and secondary endpoints were heart failure (HF)-related events and acute coronary syndrome (ACS), respectively. Cox proportional hazard models were applied to calculate hazard ratios (HRs). Receiver operating characteristic (ROC) curves and areas under the curve (AUC) were used to evaluate the prediction of the H2FPEF score for adverse outcomes.ResultsOver a mean follow-up of 40.46 ± 6.52 months, the primary and secondary endpoints occurred in 168 patients (33.8%) and 97 patients (19.5%), respectively. By the definition of obesity as BMI ≥ 25 kg/m2, a higher incidence of HF-related events and ACS was observed among those with a higher modified H2FPEF score. The modified H2FPEF significantly predicted HF-related events (AUC: 0.723; 95% confidence interval (CI): 0.676 - 0.770; P < 0.001) and ACS (AUC: 0.670; 95% CI: 0.608 - 0.731; P < 0.014) with higher power than the H2FPEF score calculated by BMI ≥ 30 kg/m2. The cutoff of the modified H2FPEF score was 6.5 for detecting HF-related events and ACS.ConclusionsThe modified H2FPEF score, using BMI ≥ 25 kg/m2 to define obesity, could more effectively predict the occurrence of subsequent cardiovascular events in Chinese HFpEF patients. The modified H2FPEF score above 6.5 is a risk factor for adverse cardiovascular events in HFpEF patients.

Dataset Information

Identification of Patients with Preclinical Heart Failure with preserved Ejection Fraction Using the H₂FPEF Score.

Publications

Identification of Patients with Preclinical Heart Failure with preserved Ejection Fraction Using the H<sub>2</sub>FPEF Score.

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