Incorporating angina into the H ₂ FPEF score improves diagnostic performance for HFpEF in women

Figures

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  Figure 1. Diagnostic performance of the H2FPEF score in the UHFO-DM cohort Radar plots show accuracy, sensitivity, specificity, PPV, NPV and AUC for the overall population (A), women (C) and men (D). ROC curves are presented separately for women and men (B). AUC, area under the curve; HFpEF, heart failure with preserved ejection fraction; NPV, negative predictive value; PPV, positive predictive value; ROC, receiver operating characteristic.

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  Figure 2. Multivariable analysis of H2FPEF components and angina in the UHFO-DM cohort Forest plots display ORs with 95% CI for H2FPEF components and angina in women (A) and men (B). Variables with ‘-z’ were standardised as z-scores to allow comparability. Variable importance, quantified by Wald χ² minus df, is shown in bar plots for women (C) and men (D). AF, atrial fibrillation; Anti-HTN drugs, antihypertensive drugs; BMI, body mass index; PASP, pulmonary artery systolic pressure.

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  Figure 3. Comparison of the original and modified H2FPEF score in women of the UHFO-DM cohort. (A) ROC curves for the original and modified H2FPEF score. (B) Radar plots of accuracy, sensitivity, specificity, PPV, NPV and AUC. (C) Calibration with observed versus predicted probabilities across categories of the modified score. (D) Decision curve analysis comparing net clinical benefit across a range of threshold probabilities. AUC, area under the curve; HFpEF, heart failure with preserved ejection fraction; NPV, negative predictive value; PPV, positive predictive value; ROC, receiver operating characteristic.

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  Figure 4. Modified H2FPEF score in women The table lists clinical variables, definitions, and assigned points for the modified H2FPEF score in women. The total score ranges from 0 to 10. The probability of HFpEF corresponding to each score is shown below. AF, atrial fibrillation; BMI, body mass index; HFpEF, heart failure with preserved ejection fraction; PASP, pulmonary artery systolic pressure.

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  Figure 5. Association between angina and HFpEF in the Combination cohort Forest plots display ORs with 95% CI for H2FPEF components, including angina in women (A) and men (B). Variables with “-z” were standardised as z-scores to allow comparability. AF, atrial fibrillation; anti-HTN drugs, antihypertensive drugs; BMI, body mass index.