H2FPEF Score for the Prediction of Exercise Intolerance and Abnormal Hemodynamics in Japanese　― Evaluation by Exercise Stress Echocardiography Combined With Cardiopulmonary Exercise Testing

• Published in: Circulation Journal 2019/11/25, Vol.83(12), pp.2487-2493
• Main Authors: Takahari, Kosuke, Hidaka, Takayuki, Ueda, Yusuke, Izumi, Kanako, Harada, Yu, Susawa, Hitoshi, Kinoshita, Mirai, Itakura, Kiho, Utsunomiya, Hiroto, Kihara, Yasuki
• Format: Article
• Language: English
• Subjects: Cardiopulmonary exercise testing; Echocardiography; H2FPEF score; Heart failure; Heart failure with preserved ejection fraction (HFpEF)
• ISSN: 1346-9843; 1347-4820; 1347-4820
• DOI: 10.1253/circj.CJ-19-0699

Background:Both the H2FPEF-score and nomogram-score, which consist of simple clinical parameters, can assist in diagnosing “early” heart failure with preserved ejection fraction (HFpEF) and only exertional dyspnea, but their these usefulness in Japanese remains unclear. We sought to investigate the correlation between these scores and exercise response, including the peak oxygen uptake (V̇O2), the pulmonary artery systolic pressure (PASP), the ratio of early diastolic transmitral flow velocity to early diastolic mitral annular velocity (E/e’) and stroke volume (SV) using exercise stress echocardiography (ESE) combined with cardiopulmonary exercise testing (CPET).Methods and Results:In this single-center, retrospective cross-sectional study the H2FPEF-score and nomogram-score were calculated in a total of 139 patients who underwent ESE combined with CPET. The scores correlated with peak V̇O2(r=−0.48, r=−0.44), PASP (r=0.23, r=0.29) and SV (r=−0.32, r=−0.19) at peak exercise. The nomogram-score correlated with E/e’ (r=0.24). The prevalence of exercise intolerance (percent predicted peak V̇O2