How to Diagnose Heart Failure with Preserved Ejection Fraction: The HFA–PEFF Diagnostic Algorithm: A Consensus Recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)
Why the study?
Making a firm diagnosis of chronic heart failure with preserved ejection fraction remains a clinical challenge.
How should heart failure with preserved ejection fraction (HFpEF) be diagnosed in clinical practice?
Design
Consensus recommendation
Authors
Discussion
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Member takes
Implication
Should not yet change HFpEF diagnostic practice; leaves open prospective validation of HFA-PEFF.
Key Points
- This research aims to establish a clear diagnostic algorithm for heart failure with preserved ejection fraction (HFpEF).
- Developed a stepwise diagnostic algorithm (HFA–PEFF) based on clinical assessment and echocardiography.
- Included evaluation of natriuretic peptides and defined criteria for diagnosis.
- Recommended additional functional testing for cases with diagnostic uncertainty.
- A score of ≥5 points from echocardiographic measures confirms HFpEF diagnosis.
- Scores of ≤1 point suggest HFpEF is unlikely, while 2–4 points indicate diagnostic uncertainty.
- Established criteria enhance clarity in diagnosing HFpEF, needing further validation.
Structured PICO
How should heart failure with preserved ejection fraction (HFpEF) be diagnosed in clinical practice?
P
Population
Patients with suspected heart failure with preserved ejection fraction (HFpEF)
I
Intervention
HFA-PEFF diagnostic algorithm (4-step process: Pre-test assessment, Echocardiography and Natriuretic Peptide Score, Functional testing, Final aetiology)
O
Outcome
Diagnosis of HFpEF
The HFA-PEFF algorithm provides a standardized, stepwise clinical and echocardiographic scoring system to improve the diagnosis of HFpEF.
Limitations
- Further research is needed for a better classification of HFpEF
Cite This Study
Pieske et al. (2020) studied this question.