Heart failure & cardiomyopathies
A scoring system for diagnosing heart failure with preserved ejection fraction based on exercise echocardiography
Authors' conclusion
The ESE score, which is based on three echocardiographic variables, may be an effective tool for diagnosing HFpEF on exercise echocardiography.
Study context
- Population
- Patients with dyspnoea who underwent exercise right heart catheterization and ESE61 heart failure with preserved ejection fraction (HFpEF) and 20 controls, validation cohort of 620 dyspnoeic patients · HFpEF 61 · controls 20
- Participants
- 81 patients
- Index test or model
- ESE score vs diagnosis of HFpEF ascertained by directly-measured haemodynamics
- Target condition
- heart failure with preserved ejection fraction (HFpEF)
Methodological detailsconsecutive patients, logistic regression analysis
- Consecutive patients
- Logistic regression analysis
Performance
As reported in the abstract
- AUC
- 0.90
- P
- P < 0.0001
Further findings
| Outcome | HR (per 1-point increase) (95% CI) | P value | |
|---|---|---|---|
| All-cause mortality or worsening HF events (cohort of 620 dyspnoeic patients)Adjusted for confounders | 1.17 (1.00–1.37) | P = 0.04 | |
| 0.512Hazard ratio (log scale) |
ESE score vs ASE/ESCVI criteria
- Superior diagnostic ability to the ASE/ESCVI criteria (AUC comparison)
- P < 0.0001
HFpEF probability by ESE score category
- Low risk
- 28%
- Intermediate risk
- 59-83%
- High risk
- 95-99%
Independent predictors of HFpEF (multivariable logistic regression)
- Resting left atrial reservoir strain < 20%
- Exercise septal E/e′ ratio > 13
- Increases in ultrasound B-lines
- Weighted score ranging from 0 to 5
Original publication
A scoring system for diagnosing heart failure with preserved ejection fraction based on exercise echocardiography. Eur Heart J Cardiovasc Imaging. Published 3 February 2025. doi:10.
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