Predictive Value of HFA-PEFF Score in Patients With Heart Failure With Preserved Ejection Fraction

Abstract

Aims: HFA-PEFF score has been proposed for diagnosing heart failure with preserved ejection fraction (HFpEF). Currently, there are only a limited number of tools for predicting the prognosis. In this study, we evaluated whether the HFA-PEFF score can predict mortality in patients with HFpEF.Methods: This single-center, retrospective observational study enrolled patients diagnosed with HFpEF at the First Affiliated Hospital of Dalian Medical University between January 1, 2015, and April 30, 2018. The subjects were divided according to their HFA-PEFF score into low (0–2 points), intermediate (3–4 points), and high (5–6 points) score groups. The primary outcome was all-cause mortality.Results: A total of 358 patients (mean age: 70.21 ± 8.64 years, 58.1% female) were included. Of these, 63 (17.6%), 156 (43.6%), and 139 (38.8%) were classified into the low, intermediate, and high score groups, respectively. Over a mean follow-up of 26.9 months, 46 patients (12.8%) died. The percentage of patients who died in the low, intermediate, and high score groups were 1 (1.6%), 18 (11.5%), and 27 (19.4%), respectively. A multivariate Cox regression identified HFA-PEFF score as an independent predictor of all-cause mortality [hazard ratio (HR):1.314, 95% CI: 1.013–1.705, P = 0.039]. A Cox analysis demonstrated a significantly higher rate of mortality in the intermediate (HR: 4.912, 95% CI 1.154–20.907, P = 0.031) and high score groups (HR: 5.291, 95% CI: 1.239–22.593, P = 0.024) than the low score group. A receiver operating characteristic (ROC) analysis indicated that the HFA-PEFF score can effectively predict all-cause mortality after adjusting for age and New York Heart Association (NYHA) class [area under the curve (AUC) 0.726, 95% CI 0.651–0.800, P = 0.000]. With an HFA-PEFF score cut-off value of 3.5, the sensitivity and specificity were 78.3 and 54.8%, respectively. The AUC on ROC analysis for the biomarker component of the score was similar to that of the total score.Conclusions: The HFA-PEFF score can be used both to diagnose HFpEF and predict the prognosis. The higher scores are associated with higher all-cause mortality.

EAT Thickness as a Predominant Feature for Evaluating Arterial Stiffness in Patients with Heart Failure with Preserved Ejection Fraction

“… 12 , 13 The H2FPEF and HFA-PEFF scores have been proposed to be useful markers for HFpEF and predicting outcomes. 21 , 22 In our study, the thicker EAT was evidently associated with higher H2FPEF score and HFA-PEFF score, suggesting that EAT might probably serve as an indicator for the severity and prognosis of HFpEF.…”

Efficacy of guideline‐directed medical treatment in heart failure with mildly reduced ejection fraction

“…Our results supported that the response to medical treatment in HFmrEF was more similar to patients with reduced LVEF and complement our previous analysis in different HF subpopulations. [13][14][15][16][17] Interestingly, in our study, the baseline left ventricular diameter and brain natriuretic peptide level in TT group were higher than that of NTT group, indicating more severe HF in the TT group. It was possible that cardiologists considered patients with greater severity of illness, where the GDMT may be more appropriate.…”

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.…”