Heart failure & cardiomyopathiesDiagnostic or prognostic study

Improving the Diagnosis of Heart Failure with Preserved Ejection Fraction (HFpEF)

JACC Cardiovasc ImagingPublished

  • Diagnostic accuracy study

Authors' conclusion

The H2FPEF score has good accuracy in excluding HF diagnosis when HF probability based on the score is <30%. When probability is >30%, 2025 ASE diastolic function guidelines approach to the estimation of mean left atrial pressure adds to accuracy.

Study context

Population
Stable patients with EF ≥50% who underwent right heart catheterization and echocardiographic imaging within 30 days237 with PCWP >15 mm Hg rest or >25 mm Hg exercise
Participants
511 patients
Comparison
H2FPEF score plus echocardiographic assessment vs H2FPEF score alone

Performance

As reported in the abstract

Accuracy of H2FPEF score with added echocardiographic assessment

Accuracy not improved by adding echocardiography when HF probability <30%

P = 0.083

Net reclassification improvement

1.38 (P < 0.001)

Integrated discrimination improvement

0.38 (P < 0.001)

Original publication

Improving the Diagnosis of HFpEF. JACC Cardiovasc Imaging. Published 25 October 2025. doi:10.1016/j.jcmg.2025.09.011

Summarised from the published abstract; every number is checked against it