Korean J Intern Med.  2022 Jan;37(1):96-108. 10.3904/kjim.2021.272.

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

• Egashira K
• Sueta D
• Komorita T
• Yamamoto E
• Usuku H
• Tokitsu T
• Fujisue K
• Nishihara T
• Oike F
• Takae M
• Hanatani S
• Takashio S
• Ito M
• Yamanaga K
• Araki S
• Soejima H
• Kaikita K
• Matsushita K
• Tsujita K

• KMID: 2524245
• DOI: http://doi.org/10.3904/kjim.2021.272

Abstract

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.

Keyword

Heart failure; Prognosis; Follow-up studies