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

• Published in: The Korean journal of internal medicine 2022-01, Vol.37 (1), p.96
• Main Authors: Koichi Egashira, Daisuke Sueta, Takashi Komorita, Eiichiro Yamamoto, Hiroki Usuku, Takanori Tokitsu, Koichiro Fujisue, Taiki Nishihara, Fumi Oike, Masafumi Takae, Shinsuke Hanatani, Seiji Takashio, Miwa Ito, Kenshi Yamanaga, Satoshi Araki, Hirofumi Soejima, Koichi Kaikita, Kenichi Matsushita, Kenichi Tsujita
• Format: Article
• Language: Korean
• Subjects: Follow-up studies; Heart failure; Prognosis
• ISSN: 1226-3303; 2005-6648

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.