Jia Xiao-Yan, Liu Li-Xiang, Wang Dong-Wei, Ma Xi-Wen, Liu Yong-Ming
1 Department of Medical Record Management,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China.
2 Department of Geriatric Cardiology,Gansu Provincial Clinical Research Center for Geriatric Medicine,The First Hospital of Lanzhou University,Lanzhou 730000,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2024 Apr;46(2):154-160. doi: 10.3881/j.issn.1000-503X.15826.
Objective To analyze the diagnostic values of HFPEF and HFA-PEFF scores for heart failure with preserved ejection fraction (HFpEF) and HFpEF complicated with atrial fibrillation (HFpEF-AF) in Chinese patients and explore the related factors. Methods A cross-sectional study was conducted.A total of 835 consecutive HFpEF patients treated in the Department of Geriatric Cardiology,the First Hospital of Lanzhou University from 2009 to 2020 were selected and assigned to a HFpEF-AF group (=267) and a HFpEF group (=568) according to the presence of AF or not.HFA-PEFF and HFPEF scores were used for retrospective diagnosis and the diagnostic consistency of the two scores was assessed.One hundred and thirty-six healthy volunteers with age and sex matching the patients during the same period were selected as healthy controls.The receiver operating characteristic (ROC) curves were established for HFPEF and HFA-PEFF scores in diagnosing HFpEF-AF and HFpEF,on the basis of which the diagnostic performance of the two scores was evaluated. Results There was no difference in the HFA-PEFF score between the two groups (=0.070).However,the HFpEF-AF group had higher mean HFPEF score and higher proportion of patients with the score no less than 6 than the HFpEF group (<0.001).According to the ROC curves,HFA-PEFF and HFPEF scores demonstrated high performance in diagnosing all HFpEF patients,with the area under the curve (AUC) of 0.892 and 0.922 and the optimal cut-offs of 4 and 4,respectively.The HFA-PEFF score showed similar performance in diagnosing HFpEF and HFpEF-AF,with the AUC of 0.899 and 0.911,respectively.The HFPEF score had higher performance in diagnosing HFpEF-AF (AUC of approximately 1.000) and low performance in diagnosing HFpEF (AUC of 0.885). Conclusions The HFA-PEFF score is applicable in the diagnosis of both HFpEF and HFpEF-AF.The HFPEF score may underestimate HFpEF in Chinese patients,and its applicability in the Chinese patients with HFpEF alone remains to be investigated.
目的 分析HFPEF和HFA - PEFF评分对中国患者射血分数保留的心力衰竭(HFpEF)及合并心房颤动的HFpEF(HFpEF - AF)的诊断价值,并探讨相关因素。方法 进行一项横断面研究。选取2009年至2020年在兰州大学第一医院老年心内科连续治疗的835例HFpEF患者,根据是否存在房颤分为HFpEF - AF组(n = 267)和HFpEF组(n = 568)。采用HFA - PEFF和HFPEF评分进行回顾性诊断,并评估两种评分的诊断一致性。选取136例年龄和性别与同期患者匹配的健康志愿者作为健康对照。绘制HFPEF和HFA - PEFF评分诊断HFpEF - AF和HFpEF的受试者工作特征(ROC)曲线,在此基础上评估两种评分的诊断性能。结果 两组间HFA - PEFF评分无差异(P = 0.070)。然而,HFpEF - AF组的平均HFPEF评分高于HFpEF组,且评分≥6分的患者比例更高(P < 0.001)。根据ROC曲线,HFA - PEFF和HFPEF评分在诊断所有HFpEF患者时表现良好,曲线下面积(AUC)分别为0.892和0.922,最佳截断值分别为4和4。HFA - PEFF评分在诊断HFpEF和HFpEF - AF时表现相似,AUC分别为0.899和0.911。HFPEF评分在诊断HFpEF - AF时性能较高(AUC约为1.000),而在诊断HFpEF时性能较低(AUC为0.885)。结论 HFA - PEFF评分适用于HFpEF和HFpEF - AF的诊断。HFPEF评分可能低估中国患者的HFpEF,其在中国单纯HFpEF患者中的适用性仍有待研究。