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Abstract of the day - How do different diagnostic HFpEF algorithms compare?

28 Aug 2021
Abstract of the day

Diagnosis of heart failure with preserved ejection fraction (HFpEF) is challenging. At a ‘Highlights from the Young’ session, Doctor Julius Nikorowitsch (University Heart & Vascular Center Hamburg, Germany) describes an analysis to compare how the 2016 ESC HF guidelines algorithm, the H2FPEF (Heavy, 2 or more hypertensive drugs, atrial fibrillation, Pulmonary hypertension, Elder age > 60, elevated Filling pressures) algorithm and the HFA-PEFF score (echocardiography and natriuretic peptides) performed for diagnosing and characterising HFpEF in the general population.

The analysis used data from 5,613 participants in the Hamburg City Health Study who had a mean age of 62 years (51% were women). Of the 407 (7.3%) individuals with unexplained dyspnoea, the estimated prevalence of HFpEF was 20.4% using ESC 2016 guideline criteria, 12.3% using H2FPEF and 7.6% using HFA-PEFF. The majority of subjects were classified as ‘HFpEF not excludable’ according to H2FPEF (59.2%) and HFA-PEFF (57.7%).

Overlap of individuals diagnosed with the different HFpEF algorithms was limited. Furthermore, the distribution of comorbidities (e.g. atrial fibrillation, diabetes and arterial hypertension) and risk factors (e.g. age and body mass index) varied between the differently diagnosed HFpEF groups.

The authors conclude that, despite HFpEF being relatively common in the middle-aged general population, the available algorithms detect different discordant subpopulations, and that further work is still needed to improve diagnosis.


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