The HFpEF-ABA score facilitates rapid and efficient screening for undiagnosed HFpEF risk in patients with dyspnea by utilizing just age, body mass index, and a history of atrial fibrillation, the researchers wrote.
Heart failure with preserved ejection fraction is frequently under-recognized in clinical settings. While the H2FPEF risk score can estimate the likelihood of HFpEF, it relies on imaging data that is not always accessible. Yogesh N. V. Reddy, The Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA, and colleagues sought to develop an HFpEF screening model based exclusively on clinical variables that can guide the need for echocardiography and further testing.
The following were the main findings of the study:
- In a derivation cohort (n = 414, 249 women), a clinical model using age, body mass index, and history of atrial fibrillation (termed the HFpEF-ABA score) showed good discrimination (area under the curve (AUC) = 0.839).
- The performance of the model was validated in an international, multicenter cohort (n = 736, 443 women; AUC = 0.813) and further validated in two additional cohorts: a cohort including patients with unexplained dyspnea (n = 228, 136 women; AUC = 0.840) and a cohort for which HF hospitalization was used instead of hemodynamics to establish an HFpEF diagnosis (n = 456, 272 women; AUC = 0.929).
- Model-based probabilities were also associated with increased risk of HF hospitalization or death among patients from the Mayo Clinic (n = 790) and a US national cohort across the Veteran Affairs health system (n = 3076, 110 women).
The HFpEF-ABA score represents a significant step forward in managing heart failure with preserved ejection fraction. By offering a reliable and evidence-based method for screening, it promises to enhance diagnostic accuracy and ultimately improve patient outcomes in the fight against heart failure, the researchers concluded.
Reference:
Reddy, Y. N., Carter, R. E., Sundaram, V., Kaye, D. M., Handoko, M. L., Tedford, R. J., Andersen, M. J., Sharma, K., Obokata, M., Verbrugge, F. H., & Borlaug, B. A. (2024). An evidence-based screening tool for heart failure with preserved ejection fraction: The HFpEF-ABA score. Nature Medicine, 1-7. https://doi.org/10.1038/s41591-024-03140-1
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