In-Chang Hwang1, Goo-Yeong Cho2, Hong-Mi Choi3, Yeonyee E Yoon1, Jin Joo Park1, Jun-Bean Park4, Jae-Hyeong Park5, Seung-Pyo Lee4, Hyung-Kwan Kim4, Yong-Jin Kim4. 1. Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, South Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea. 2. Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, South Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: cardioch@snu.ac.kr. 3. Division of Cardiology, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Gyeonggi, South Korea. 4. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea; Cardiovascular Center and Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea. 5. Department of Cardiology, Internal Medicine, Chungnam National University Hospital, Daejeon, South Korea.
Abstract
BACKGROUND: The H2FPEF score is a validated algorithm for the diagnosis of heart failure with preserved ejection fraction (HFpEF). We investigated the associations of the H2FPEF score with echocardiographic parameters and prognosis in patients with HFpEF admitted for acute heart failure. METHODS AND RESULTS: In total, 4312 patients at 3 tertiary centers were identified. Among 1335 patients with HFpEF, the H2FPEF score was available in 1105 patients (39% male) with a median age of 77 years (interquartile range 69-82). The median H2FPEF score was 4 (interquartile range 3-6). Patients with higher H2FPEF scores had worse left atrial (LA) size, peak atrial longitudinal strain of the left atrium, mitral E/e' ratio, and peak tricuspid regurgitation velocity. Peak atrial longitudinal strain of the left atrium demonstrated a significant association with the H2FPEF score, in patients without atrial fibrillation and those without atrial fibrillation. After adjustment for clinical factors and echocardiographic parameters, patients with higher H2FPEF scores had a higher risk of mortality and hospitalization for heart failure, regardless of the presence of atrial fibrillation. CONCLUSIONS: The H2FPEF score reflects left atrial function in patients with HFpEF admitted for acute heart failure. This association supports the clinical usefulness of the H2FPEF score as an indicator of diastolic dysfunction, a diagnostic algorithm for HFpEF, and a prognostic factor in patients with HFpEF.
BACKGROUND: The H2FPEF score is a validated algorithm for the diagnosis of heart failure with preserved ejection fraction (HFpEF). We investigated the associations of the H2FPEF score with echocardiographic parameters and prognosis in patients with HFpEF admitted for acute heart failure. METHODS AND RESULTS: In total, 4312 patients at 3 tertiary centers were identified. Among 1335 patients with HFpEF, the H2FPEF score was available in 1105 patients (39% male) with a median age of 77 years (interquartile range 69-82). The median H2FPEF score was 4 (interquartile range 3-6). Patients with higher H2FPEF scores had worse left atrial (LA) size, peak atrial longitudinal strain of the left atrium, mitral E/e' ratio, and peak tricuspid regurgitation velocity. Peak atrial longitudinal strain of the left atrium demonstrated a significant association with the H2FPEF score, in patients without atrial fibrillation and those without atrial fibrillation. After adjustment for clinical factors and echocardiographic parameters, patients with higher H2FPEF scores had a higher risk of mortality and hospitalization for heart failure, regardless of the presence of atrial fibrillation. CONCLUSIONS: The H2FPEF score reflects left atrial function in patients with HFpEF admitted for acute heart failure. This association supports the clinical usefulness of the H2FPEF score as an indicator of diastolic dysfunction, a diagnostic algorithm for HFpEF, and a prognostic factor in patients with HFpEF.
Authors: Harrison Stubbs; Alexander MacLellan; Michael McGettrick; Bhautesh Jani; Melanie Brewis; Colin Church; Martin Johnson Journal: Open Heart Date: 2022-04
Authors: Alex N Smith; Raffaele Altara; Ghadir Amin; Nada J Habeichi; Daniel G Thomas; Seungho Jun; Abdullah Kaplan; George W Booz; Fouad A Zouein Journal: J Am Heart Assoc Date: 2022-07-29 Impact factor: 6.106