Cohort study
Prognostic benefit of early diagnosis with exercise stress testing in heart failure with preserved ejection fraction
- Prospective cohort study
Authors' conclusion
Identification of HFpEF by exercise stress testing may allow risk stratification in dyspnoeic patients. Furthermore, initiation of guideline-directed therapy may be associated with improved clinical outcomes in patients with early-stage HFpEF.
Study context
- Population
- Patients with exertional dyspnoea undergoing ergometry exercise stress echocardiography
- Participants
- 368 patients
- Exposure
- HFpEF diagnosed by exercise stress testing vs non-cardiac dyspnoea
- HFpEFn = 182
- Controlsn = 186reference
- Outcome
- All-cause mortality and worsening heart failure (HF) events
Main finding
As reported in the abstract
Hazard ratio
7.52
95% CI 2.24–25.2
P = 0.001
HFpEF vs Controls
HR 7.52 (95% CI 2.24–25.2); P = 0.001
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Composite events, early guideline-recommended therapy vs none (HFpEF; therapy started in 90) | 0.33 (0.12–0.91) | P = 0.03 | |
| 0.10.31310Hazard ratio (log scale) |
Composite events, HFA-PEFF Step 2 < 5 but ≥ 5 after exercise testing (subgroup)
- Higher risk of composite events than controls
Original publication
Prognostic benefit of early diagnosis with exercise stress testing in heart failure with preserved ejection fraction. Eur J Prev Cardiol. Published 24 April 2023. doi:10.1093/eurjpc/zwad127
Summarised from the published abstract; every number is checked against it