Noninvasive left ventricular end-diastolic pressure assessment using a novel workflow and device in primary care settings to enhance heart failure diagnosis

Objective . Heart failure (HF) is underdiagnosed in high-risk patients, motivating the development of screening workflows towards earlier identification. The objective of this study is to evaluate the feasibility and screening yield of a non-provider-based, noninvasive left ventricular end-diastolic pressure (LVEDP) assessment as a marker of HF risk within routine outpatient primary care settings. Approach . A dedicated, screening-only ‘heart health clinic’ workflow, using noninvasive estimation of LVEDP and the Kansas City Cardiomyopathy Questionnaire (KCCQ-12), was assessed. Primary care patients at high-risk for HF were contacted directly and scheduled for focused screening visits performed by trained medical assistant ‘superusers,’ independent of a provider visit. Main results . Of n = 1238 patients who arrived for screening, n = 1141 ( 92.2 % ) had conclusive LVEDP estimates. LVEDP was estimated to be elevated (defined as > 18 mmHg) in 40.1% of screened patients, with a higher prevalence in women than men (46.6% vs. 31.9%; p < 0.0001). Age and body mass index were found to be similar between elevated and non-elevated LVEDP groups. Among patients with elevated LVEDP, 426 (93.0%) completed all KCCQ-12 subdomains, with overall summary (OS) scores classifying 42.3% as asymptomatic Stage-B HF (KCCQ-OS = 100), 45.1% as New York Heart Association (NYHA) I (KCCQ-OS 80–99), and the rest as NYHA II–IV (KCCQ-OS < 80 ). Significance . These findings indicate that the overall workflow does not introduce significant bias, supporting the practicality and feasibility of incorporating noninvasive LVEDP assessment into scalable HF risk screening in general outpatient populations.