Heart failure with preserved ejection fraction according to the HFA‐PEFF score in COVID‐19 patients: clinical correlates and echocardiographic findings

Aims Viral‐induced cardiac inflammation can induce heart failure with preserved ejection fraction (HFpEF)‐like syndromes. COVID‐19 can lead to myocardial damage and vascular injury. We hypothesised that COVID‐19 patients frequently develop a HFpEF‐like syndrome, and designed this study to explore th...

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Bibliographic Details
Published in:European Journal of Heart Failure 2021-11, Vol.23 (11), p.1891-1902
Main Authors: Hadzibegovic, Sara, Lena, Alessia, Churchill, Timothy W., Ho, Jennifer E., Potthoff, Sophia, Denecke, Corinna, Rösnick, Lukas, Heim, Katrin Moira, Kleinschmidt, Malte, Sander, Leif Erik, Witzenrath, Martin, Suttorp, Norbert, Krannich, Alexander, Porthun, Jan, Friede, Tim, Butler, Javed, Wilkenshoff, Ursula, Pieske, Burkert, Landmesser, Ulf, Anker, Stefan D., Lewis, Gregory D., Tschöpe, Carsten, Anker, Markus S.
Format: Article
Language:English
Subjects:
Adult
Aged
COVID-19
Diastolic dysfunction
Echocardiography
Female
Heart Failure - epidemiology
HFA‐PEFF
High‐sensitivity troponin T
Humans
Middle Aged
NT‐proBNP
SARS-CoV-2
Stroke Volume
Ventricular Function, Left
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Summary:Aims Viral‐induced cardiac inflammation can induce heart failure with preserved ejection fraction (HFpEF)‐like syndromes. COVID‐19 can lead to myocardial damage and vascular injury. We hypothesised that COVID‐19 patients frequently develop a HFpEF‐like syndrome, and designed this study to explore this. Methods and results Cardiac function was assessed in 64 consecutive, hospitalized, and clinically stable COVID‐19 patients from April–November 2020 with left ventricular ejection fraction (LVEF) ≥50% (age 56 ± 19 years, females: 31%, severe COVID‐19 disease: 69%). To investigate likelihood of HFpEF presence, we used the HFA‐PEFF score. A low (0–1 points), intermediate (2–4 points), and high (5–6 points) HFA‐PEFF score was observed in 42%, 33%, and 25% of patients, respectively. In comparison, 64 subjects of similar age, sex, and comorbidity status without COVID‐19 showed these scores in 30%, 66%, and 4%, respectively (between groups: P = 0.0002). High HFA‐PEFF scores were more frequent in COVID‐19 patients than controls (25% vs. 4%, P = 0.001). In COVID‐19 patients, the HFA‐PEFF score significantly correlated with age, estimated glomerular filtration rate, high‐sensitivity troponin T (hsTnT), haemoglobin, QTc interval, LVEF, mitral E/A ratio, and H2FPEF score (all P 
ISSN:1388-9842
1879-0844
DOI:10.1002/ejhf.2210