Heart failure & cardiomyopathiesCohort study
The LEDA Score
- prospective single-center study
Authors' conclusion
In this selected cohort undergoing an invasive hemodynamic assessment for diagnostic uncertainty, LEDA showed stronger diagnostic performance than contemporary HFpEF diagnostic algorithms and an echocardiographic filling-pressure framework. External validation is required before application to broader outpatient populations.
Study context
- Population
- Selected patients with unexplained dyspnea who underwent echocardiography and an invasive hemodynamic assessment within 24 hoursselected patients with unexplained dyspnea
- Participants
- 171 patients
- Exposure
- Diagnostic performance of LEDA compared with H2FPEF and HFA-PEFF, and 2025 American Society of Echocardiography diastolic criteria, for heart failure with preserved ejection fraction (HFpEF) defined by symptoms or signs of heart failure with elevated N-terminal pro-B-type natriuretic peptide and/or invasively measured left-sided filling pressure (LSFP) ≥15 mm Hg
Main finding
As reported in the abstract
HFpEF prevalence
HFpEF present
42%
Observational data: associations, not effects.
Further findings
| Outcome | LEDA | H2FPEF | HFA-PEFF | American Society of Echocardiography criteria |
|---|---|---|---|---|
| Discrimination for HFpEF (area under the curve) | area under the curve 0.85 | area under the curve 0.74 | area under the curve 0.74 | area under the curve 0.61 |
| Positive likelihood ratio for HFpEF at LEDA ≥3 | positive likelihood ratio 7.4 | positive likelihood ratio 3.0 | positive likelihood ratio 1.8 | positive likelihood ratio 1.6 |
- LEDA performance for invasive LSFP endpoints
- 0.90 · area under the curve up to · specificity up to 95.5% · positive likelihood ratio up to 16.3
- Discrimination for HFpEF (area under the curve): LEDA higher discrimination than the comparators, P ≤ 0.010
Original publication
The LEDA Score. JACC Adv. Published 18 September 2026. doi:10.1016/j.jacadv.2026.103246
Summarised from the published abstract; every number is checked against it