Key result
Modern HFpEF diagnostic algorithms differ in accuracy and often require specialized confirmatory testing.
Why the study?
While criteria for evaluating heart failure with reduced ejection fraction are well described in current guidelines, the timely diagnosis of chronic heart failure with preserved ejection fraction remains an unsolved issue.
This review summarizes and compares four major contemporary diagnostic algorithms for heart failure with preserved ejection fraction to aid clinical evaluation.
Answers are grounded in this paper and cite their sources.
May require additional testing for HFpEF confirmation; leaves open standardization of diagnostic algorithms.
Chronic heart failure remains one of the main causes of mortality and reduced life quality both in Ukraine and around the world. More than 50 % of all patients with chronic heart failure are those with preserved left ventricular ejection fraction. In current guidelines, the criteria for evaluating heart failure with reduced left ventricular ejection fraction are described properly, but the issue of timely diagnosing chronic heart failure with preserved ejection fraction still remains unsolved. This review presents four diagnostic algorithms for this condition, which were presented by international scientific societies in recent years: 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure; H2FPEF Score for Heart Failure with Preserved Ejection Fraction (Mayo, 2018); HFA-PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) (2019); Multimodality imaging in patients with heart failure and preserved ejection fraction: an expert consensus document of the European Association of Cardiovascular Imaging (2021). The main advantages, limitations and disadvantages of each one are analyzed. All steps of diagnostic evaluation are described in detail. The review is illustrated with patterns of the latest diagnostic approaches.
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Kolesnyk et al. (2023) conducted a review in Chronic heart failure with preserved left ventricular ejection fraction. Diagnostic algorithms (ESC 2021, H2FPEF, HFA-PEFF, EACVI 2021) was evaluated. Modern diagnostic algorithms for heart failure with preserved ejection fraction differ significantly in sensitivity and specificity, often requiring additional specialized testing for confirmation.
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