Heart failure & cardiomyopathies
The LEDA Score: An Integrated Echocardiographic Score for the Diagnosis of Heart Failure with Preserved Ejection Fraction (HFpEF)
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 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: An Integrated Echocardiographic Score for the Diagnosis of HFpEF. JACC Adv. Published 18 September 2026. doi:10.
Summarised from the published abstract; every number is checked against it