ABC Heart Fail Cardiomyop 2022; 2(3): 275-280

Diagnostic Scores in Heart Failure with Preserved Ejection Fraction

Miguel Morita Fernandes-Silva

DOI: 10.36660/abchf.20220057

Abstract

The diagnosis of heart failure with preserved ejection fraction (HFpEF) can be challenging and diagnostic scores have been proposed to help in the diagnostic process. This article reviews these scores to provide insights on their role and interpretation in clinical practice. To date, two scores have been validated for the diagnosis of HFpEF. The H2FPEF includes clinical – obesity, hypertension, atrial fibrillation, age – and echocardiographic data – pulmonary hypertension and E/e’ ratio. The HFA-PEFF uses multiple echocardiographic parameters on structural and functional cardiac abnormalities and includes natriuretic peptide blood levels. The accuracy of the H2FPEF score appear to be superior to the HFA-PEFF score in identifying patients with elevated pulmonary capillary wedge pressure at rest or during exercise, but the gold-standard definition of HFpEF is still a matter of debate. A high rating in either of the two scores has a high positive predictive value, and the scores are most useful when HFpEF is clinically suspected, but the diagnosis is uncertain.