Barros Fernando Colares, Cezaro Jéssica Cristina de, Costa Pietro Donelli, Costa Giovanni Donelli, Santos Angela Barreto Santiago, Pianca Eduardo Gatti, Menegazzo Willian Roberto, Scolari Fernando Luís, Silveira Anderson Donelli da
Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS - Brasil.
Programa de Pós-graduação em Cardiologia e Ciências Cardiovasculares da UFRGS, Porto Alegre, RS - Brasil.
Arq Bras Cardiol. 2025 May;122(6):e20240852. doi: 10.36660/abc.20240852.
The H2FPEF and HFA-PEFF scores were developed to support the diagnosis of heart failure with preserved ejection fraction (HFpEF) and may also help predict cardiovascular outcomes.
To assess the prognostic value of these scores in a cohort of individuals with HFpEF.
This prospective study was conducted at a tertiary hospital in Brazil between March 2019 and December 2021. After clinical evaluation, echocardiography, and exercise testing, the H2FPEF and HFA-PEFF scores were calculated. Patients were classified into intermediate probability groups (H2FPEF: 2-5 points; HFA-PEFF: 2-4 points) and high probability groups (H2FPEF >5 points; HFA-PEFF >4 points). The primary outcome was a composite of all-cause mortality and hospitalizations due to HFpEF. Statistical significance was set at p<0.05.
A total of 103 patients were followed for an average of 888 days (±291). The mean age was 69 years (±8.3), and 61% were women. Twenty-seven patients (26.2%) experienced primary outcomes, totaling 32 events-11 deaths and 21 hospitalizations due to HFpEF. In the receiver operating characteristic (ROC) curve analysis, the H2FPEF score showed better predictive ability for the outcomes (area under the curve [AUC]: 0.637, 95% CI: 0.518-0.756, p=0.035) compared to the HFA-PEFF score (AUC: 0.572, 95% CI: 0.448-0.696, p=0.270). In the Kaplan-Meier analysis, high-probability classification by both scores was significantly associated with the occurrence of outcomes (log-rank p=0.034), compared to the intermediate score group or patients with differing classifications between the two scores.
The H2FPEF score showed better performance than the HFA-PEFF score in predicting outcomes in patients with HFpEF. Findings from this contemporary study conducted in Brazil contribute to risk stratification in clinical practice.
H2FPEF和HFA - PEFF评分是为支持射血分数保留的心力衰竭（HFpEF）的诊断而制定的，也可能有助于预测心血管结局。
评估这些评分在HFpEF患者队列中的预后价值。
这项前瞻性研究于2019年3月至2021年12月在巴西的一家三级医院进行。经过临床评估、超声心动图检查和运动测试后，计算H2FPEF和HFA - PEFF评分。患者被分为中度概率组（H2FPEF：2 - 5分；HFA - PEFF：2 - 4分）和高度概率组（H2FPEF>5分；HFA - PEFF>4分）。主要结局是全因死亡率和因HFpEF住院的复合结局。统计学显著性设定为p<0.05。
共对103例患者进行了平均888天（±291）的随访。平均年龄为69岁（±8.3），61%为女性。27例患者（26.2%）发生了主要结局，共32起事件——11例死亡和21例因HFpEF住院。在受试者工作特征（ROC）曲线分析中，与HFA - PEFF评分（曲线下面积[AUC]：0.572，95%置信区间：0.448 - 0.696，p = 0.270）相比，H2FPEF评分对结局显示出更好的预测能力（AUC：0.637，95%置信区间：0.518 - 0.756，p = 0.035）。在Kaplan - Meier分析中，与中度评分组或两组评分分类不同的患者相比，两种评分的高度概率分类均与结局的发生显著相关（对数秩检验p = 0.034）。
在预测HFpEF患者的结局方面，H2FPEF评分比HFA - PEFF评分表现更好。在巴西进行的这项当代研究结果有助于临床实践中的风险分层。
