HFA‐PEFF score: prognosis in patients with preserved ejection fraction after transcatheter aortic valve implantation

Seoudy, Hatim; Eberstein, Mira von; Frank, Johanne; Thomann, Maren; Puehler, Thomas; Lutter, Georg; Lutz, Matthias; Bramlage, Peter; Frey, Norbert; Saad, Mohammed; Frank, Derk

doi:10.1002/ehf2.13774

Cited by 15 publications

(16 citation statements)

References 30 publications

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“…In a recent observational study, a high HFA-PEFF score of a ≥5 was an independent predictor of all-cause mortality over 12 months. However, echocardiography parameters in the study were obtained after TAVI and long-term outcomes beyond 12 months were not assessed [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Its clinical usefulness was also suggested as a prognostic tool in predicting adverse outcomes in HFpEF patients [ 5 ]. Although patients with severe aortic stenosis were excluded in the formulation and validation of the HFA-PEFF score, its prognostic value was recently tested in a single-center cohort study over a period of one year [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Value of HFA-PEFF Score in Patients Undergoing Transcatheter Aortic Valve Implantation

Al-Otaibi¹,

Elbasha²,

Landt³

et al. 2022

Cureus

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BackgroundThe HFA-PEFF score may help in predicting long-term outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) for severe aortic stenosis and preserved left ventricular ejection fraction (EF). MethodsWe retrieved data from 1,332 patients undergoing TAVI between 2010 and 2019 from the Prospective Segeberg TAVI Registry (ClinicalTrials.gov Identifier: NCT03192774). We calculated the HFA-PEFF score for 1,022 patients who had preserved EF (≥50%). To assess the prognostic value of the HFA-PEFF score in predicting adverse events, we dichotomised the patients according to a cut-off score of five (score <5 group: n=528 (51.6%), score ≥5 group: n=494 (48.3%)). ResultsThe HFA-PEFF score ≥5 groups were older (81.9±6.3 years vs. 80.3±6.9 years; p<0.001) and had a higher prevalence of atrial fibrillation (35.1% vs 20.8%; p<0.001) and chronic kidney disease (30.1% vs 26.1%; p<0.001). Kaplan-Meier survival analyses over 24 months showed increased cardiovascular (CV) mortality (12.5% vs. 7.7%, log-rank; p=0.028) and first heart failure-related rehospitalisation (7.7% vs. 4.0%, log-rank p=0.014) in the HFA-PEFF score ≥5 groups compared with those of lower scores. No significant difference in all-cause mortality between both groups was observed (22.0% vs. 17.9%, log-rank p=0.127). In multivariate analysis, HFA-PEFF score ≥5 failed to predict CV mortality (aHR 1.37, 95% CI: 0.90-2.08, p=0.140) and time to first heart failure-related rehospitalisation (aHR 1.49, 95% CI: 0.83-2.65, p=0.181). ConclusionThe HFA-PEFF score showed limited value in predicting long-term mortality and adverse heart failurerelated events in patients with preserved EF undergoing TAVI. Clinical variables specific to this population could complement the HFA-PEFF score for better risk prediction.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prognostic Value of HFA-PEFF Score in Patients Undergoing Transcatheter Aortic Valve Implantation

Al-Otaibi¹,

Elbasha²,

Landt³

et al. 2022

Cureus

View full text Add to dashboard Cite

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“…Studies of vascular stiffness have raised the notion of an unmasking of maladaptive ventricular‐arterial coupling when left ventricular obstruction is relieved by AS treatment, 24,25 although its prognostic value remains to be established. In a study of AS patients with preserved ejection fraction undergoing TAVI, the HFA‐PEFF score 26 was associated with all‐cause mortality and HF rehospitalization post‐TAVI 27 . These findings point to HFpEF evaluation using the HFA‐PEFF score being applicable to AS with a potential to be incorporated into risk stratification algorithms for severe AS.…”

Section: Valvular Heart Diseasementioning

confidence: 94%

“…In a study of AS patients with preserved ejection fraction undergoing TAVI, the HFA-PEFF score 26 was associated with all-cause mortality and HF rehospitalization post-TAVI. 27 These findings point to HFpEF evaluation using the HFA-PEFF score being applicable to AS with a potential to be incorporated into risk stratification algorithms for severe AS. Another potential would be to apply HF evaluation to moderate VHD to predict the disease progression and optimize intervention timing.…”

Section: Valvular Heart Diseasementioning

confidence: 97%

A year in heart failure: updates of clinical and preclinical findings

et al. 2023

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We witnessed major advances in the management of heart failure (HF) in 2022. Results of recent clinical and preclinical investigations aid preventive strategies, diagnostic efforts, and therapeutic interventions, and collectively, they hold promises for a more effective HF care for the near future. Accordingly, currently available information extends the 2021 European Society of Cardiology guidelines and provides a solid background for the introduction of improved clinical approaches in the number of HF‐related cases. Elaboration on the relationships between epidemiological data and risk factors lead to better understanding of the pathophysiology of HF with reduced ejection fraction and HF with preserved ejection fraction. The clinical consequences of valvular dysfunctions are increasingly interpreted not only in their haemodynamic consequences but also in association with their pathogenetic factors and modern corrective treatment possibilities. The influence of coronavirus disease 2019 pandemic on the clinical care of HF appeared to be less intense in 2022 than before; hence, this period allowed to refine coronavirus disease 2019 management options for HF patients. Moreover, cardio‐oncology emerges as a new subdiscipline providing significant improvements in clinical outcomes for oncology patients. Furthermore, the introduction of state‐of‐the‐art molecular biologic methods, multi‐omic approaches forecast improved phenotyping and precision medicine for HF. All above aspects are addressed in this article that highlights a selection of papers published in ESC Heart Failure in 2022.

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“…The incidence of aortic stenosis (AS) increases with age and is a significant problem in an aging society [1][2][3]. Symptomatic severe aortic stenosis has dismal prognosis and early intervention is strongly recommended in all patients [1].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and safety of transcatheter aortic valve replacement in elderly people with severe aortic stenosis with different types of heart failure

Dong

Wang²,

Tse³

et al. 2023

BMC Cardiovasc Disord

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Background Impaired left ventricular function is an independent predictor of adverse clinical outcomes in patients with aortic stenosis. The aim of this study is to evaluate the short-term changes of echocardiographic parameters, New York Heart Association (NYHA) class and B-type natriuretic peptide (BNP) level and adverse events amongst patients with heart failure (HF) after transcatheter aortic valve replacement (TAVR) procedure. Methods This was a retrospective cohort study conducted at affiliated Yantai Yuhuangding Hospital of Qingdao University between September 2017 and September 2022. TAVR cases were stratified into three groups [heart failure with reduced ejection fraction (HFrEF), heart failure with mildly reduced ejection fraction (HFmrEF), heart failure with preserved ejection fraction (HFpEF)] by left ventricular ejection fraction (LVEF). Baseline characteristics, changes in echocardiographic parameters (1 week and 1 month), BNP (1 month), and NYHA class (6 months) post-TAVR were compared across the three groups. Meanwhile, we observed the adverse events of the patients after TAVR. Results A total of 96 patients were included, of whom 15 (15.6%) had HFrEF, 15 (15.6%) had HFmrEF, and 66 (68.8%) had HFpEF. Compared to the HFpEF subgroup, patients in the HFrEF subgroup were younger (p < 0.05), and with a higher BNP (p < 0.05). The left ventricular end-diastolic dimension (LVEDD) in HFrEF group decreased significantly after TAVR. HFmrEF and HFrEF patients showed significant improvements in LVEF after TAVR. The pulmonary artery systolic pressure (PASP), aortic valve peak gradient (AVPG) and aortic valve peak gradient (Vmax) decreased significantly 1 month after TAVR in all three groups compared to the baseline (all p < 0.05). BNP significantly reduced in HFrEF group compared to HFpEF patients after TAVR (p < 0.05). The majority of patients experienced an improvement at least one NYHA class in all three groups 6 months post-TAVR. There is no significant increase in the risk of adverse events in the HFrEF group. Conclusions Patients who underwent TAVR achieved significant improvements in BNP, NYHA class, LVEDD, LVEF, and PASP across the three HF classes, with a more rapid and pronounced improvement in the HFrEF and HFmrEF groups. Complication rates were low in the different HF groups. There is no significant increase in the risk of periprocedural complications in the HFrEF and HFmrEF groups.

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HFA‐PEFF score: prognosis in patients with preserved ejection fraction after transcatheter aortic valve implantation

Cited by 15 publications

References 30 publications

Prognostic Value of HFA-PEFF Score in Patients Undergoing Transcatheter Aortic Valve Implantation

Prognostic Value of HFA-PEFF Score in Patients Undergoing Transcatheter Aortic Valve Implantation

A year in heart failure: updates of clinical and preclinical findings

Effectiveness and safety of transcatheter aortic valve replacement in elderly people with severe aortic stenosis with different types of heart failure

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