Identification of Patients with Preclinical Heart Failure with preserved Ejection Fraction Using the HFPEF Score.

Heart failure with preserved ejection fraction (HFpEF) is a common disorder with few effective treatments. There is currently no evidence-based method to identify preclinical HFpEF. The HFPEF score is a validated instrument to identify patients with overt HFpEF. Here we show the HFPEF score can identify individuals with preclinical HFpEF. Among individuals where heart failure was excluded (n=160), increasing HFPEF score was shown to be associated with greater left atrial dilation, left ventricular hypertrophy, and more severe diastolic dysfunction. Patients with increasing HFPEF score displayed higher pulmonary artery pressures, higher left heart filling pressures, lower cardiac index, and more severely impaired aerobic capacity during exercise. In summary, we show that among adults without heart failure, higher HFPEF score is associated with subclinical abnormalities that resemble those observed in HFpEF. These findings broaden the external validity of the HFPEF score and suggest that this instrument may help identify patients positioned to benefit from preventive interventions.