Heart failure & cardiomyopathies
Utility and Validity of the HFA-PEFF and H2FPEF Scores in Patients With Symptomatic Atrial Fibrillation
Authors' conclusion
Against a gold standard of invasively diagnosed HFpEF, the HFA-PEFF and H2FPEF scores demonstrate only moderate accuracy in patients with AF and should be utilized with caution in this cohort of patients.
Study context
- Population
- Patients with symptomatic atrial fibrillation (AF) and preserved EF scheduled for AF ablation88 with invasive heart failure with preserved ejection fraction (HFpEF)
- Participants
- 120 patients
- Comparison
- HFA-PEFF vs H2FPEF score for HFpEF diagnosis
- Outcome
- Sensitivity and specificity for HFpEF vs invasive diagnosis (mean left atrial pressure at rest and after 500 mL fluid infusion)
Methodological detailsconsecutive patients, invasive gold standard
- Consecutive patients
- Invasive gold standard
Performance
As reported in the abstract
Diagnosis of HFpEF
| Test or model | AUC | Sensitivity | Specificity |
|---|---|---|---|
| HFA-PEFF | 0.663 | 40% | 91% |
| H2FPEF | 0.707 | 69% | 66% |
AUC
HFA-PEFF0.663
H2FPEF0.707
Sensitivity
HFA-PEFF40%
H2FPEF69%
Specificity
HFA-PEFF91%
H2FPEF66%
- HFA-PEFF vs H2FPEF: P = 0.636 — similar overall accuracy
Further findings
| Outcome | HFA-PEFF | H2FPEF | |
|---|---|---|---|
| Score probability categories | |||
| High probability | 38 (31.7%) | 72 (60%) | |
| Low/intermediate probability | 82 (68.3%) | Not reported in the abstract | H2FPEF: not reported in the abstract |
| Intermediate probability | Not reported in the abstract | 48 (40%) | HFA-PEFF: not reported in the abstract |
Invasively diagnosed HFpEF (prevalence)
- HFpEF
- 88 (73.3%)
- No HFpEF
- 32 (26.7%)
Original publication
Utility and Validity of the HFA-PEFF and H2FPEF Scores in Patients With Symptomatic Atrial Fibrillation. JACC Heart Fail. Published 20 March 2024. doi:10.
Summarised from the published abstract; every number is checked against it