Heart failure & cardiomyopathiesDiagnostic or prognostic study
Parsimonious echocardiography-based model for predicting long-term all-cause mortality in heart failure with preserved ejection fraction
- developed and internally validated a parsimonious echocardiography-based model
- real-world heart failure with preserved ejection fraction (HFpEF) echocardiography database linked to territory-wide electronic health records
- randomly split in a prespecified 70:30 ratio into training and validation cohorts
- Least absolute shrinkage and selection operator (LASSO)-penalised Cox regression, refitted as a multivariable Cox model
Authors' conclusion
A five-variable echocardiography-based nomogram showed better discrimination for long-term mortality prediction than the repurposed diagnostic scores evaluated in this cohort. External validation is needed before clinical implementation.
Study context
- Population
- Adults with HFpEF (left ventricular ejection fraction ≥50%) diagnosed between 2010 and 2016adults with HFpEF · training cohort 554 · validation cohort 238
- Participants
- 792 adults
- Comparison
- prognostic discrimination of the model compared with HFA-PEFF and H 2 FPEF
- Outcome
- All-cause mortality
- Follow-up
- Median 5.17 years (IQR 2.26-9.14) training; 5.75 years (IQR 2.17-9.25) validation
Performance
As reported in the abstract
Further findings
| Outcome | nomogram | HFA-PEFF | H 2 FPEF |
|---|---|---|---|
| Discrimination in the validation cohort (area under the curve) · 1/3/5 years | |||
| 1/3/5-year area under the curves | 0.658/0.706/0.713 | 0.507/0.561/0.642 | 0.516/0.533/0.607 |
Discrimination in the validation cohort (area under the curve) · 1/3/5 years
- nomogram showed better discrimination than HFA-PEFF and H 2 FPEF
Calibration · 1, 3 and 5 years
- Calibration was acceptable at 1 and 3 years but weaker at 5 years
Survival by risk-score tertiles
- risk-score tertiles separated survival in both cohorts
- log-rank p<0.001
Original publication
Parsimonious echocardiography-based model for predicting long-term all-cause mortality in heart failure with preserved ejection fraction. Heart. Published 24 March 2026. doi:10.1136/heartjnl-2026-327898
Summarised from the published abstract; every number is checked against it