Heart failure & cardiomyopathies
Improving the Diagnosis of Heart Failure with Preserved Ejection Fraction (HFpEF): A Comparison of the H2FPEF Score and the 2025 ASE Diastolic Function Guideline Recommendations Using Invasive Hemodynamics as the Gold Standard
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: A Comparison of the H2FPEF Score and the 2025 ASE Diastolic Function Guideline Recommendations Using Invasive Hemodynamics as the Gold Standard. JACC Cardiovasc Imaging. Published 25 October 2025. doi:10.
Summarised from the published abstract; every number is checked against it