Reddy et al reported the H2FPEF score for diagnosing heart failure with preserved ejection fraction (HFpEF). The authors are from the Mayo Clinic.
Patient selection: unexplained exertional dyspnea
Parameters:
(1) heavy (H) by body mass index
(2) hypertensive (H) medications
(3) atrial fibrillation (F)
(4) pulmonary hypertension (P) by Doppler echocardiography of pulmonary artery systolic pressure
(5) elder (E) by age
(6) filling pressure (F) by Doppler echocardiography E/e'
|
Parameter
|
Finding
|
Points
|
|
body mass index
|
<= 30 kg per sq m
|
0
|
|
|
> 30 kg per sq m
|
2
|
|
hypertensive medications
|
0 or 1
|
0
|
|
|
>= 2
|
1
|
|
atrial fibrillation
|
paroxysmal or persistent
|
3
|
|
|
no
|
0
|
|
pulmonary hypertension
|
PA systolic pressure <= 35 mm Hg
|
0
|
|
|
PA systolic pressure > 35 mm Hg
|
1
|
|
age
|
<= 60 years
|
0
|
|
|
> 60 years
|
1
|
|
filling pressure
|
E/e' <= 9
|
0
|
|
|
E/e' > 9
|
1
|
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
|
Total Score
|
Probability of HF
|
|
0
|
< 20%
|
|
1
|
23%
|
|
2
|
39%
|
|
3
|
56%
|
|
4
|
72%
|
|
5
|
83%
|
|
6
|
91%
|
|
7
|
95%
|
|
8 or 9
|
> 95%
|
estimated from Figure 1
Performance:
• The area under the ROC curve is 0.84.
