Key result
Novel 5-step diagnostic approach and BREATH2 score help identify unrecognized HFpEF in exertional dyspnea.
Why the study?
Recent life-saving pharmacotherapies have made HFpEF treatable, but the condition remains underdiagnosed across care settings due to diagnostic difficulties, particularly in patients with obesity or atrial fibrillation.
A structured 5-step diagnostic approach may help primary care physicians identify unrecognized HFpEF in patients with unexplained dyspnea.
May support structured HFpEF evaluation in unexplained dyspnea; leaves open prospective validation before practice change.
The development of life-saving pharmacotherapies such as the sodium-glucose cotransporter-2 inhibitors has changed heart failure with preserved ejection fraction (HFpEF) into a treatable disease. This paradigm shift in treatment has made the diagnosis of HFpEF more important. However, HFpEF is underdiagnosed in primary and secondary/tertiary care settings due to its diagnostic difficulties. Particularly, HFpEF is often missed in patients with obesity or atrial fibrillation. This review describes the reasons for the difficulty in diagnosing HFpEF and proposes a 5-step approach to identifying HFpEF in patients with unexplained dyspnea. Primary care physicians play a key role in the early identification of HFpEF in the community. We also discuss potential approaches to enhancing community referral and thus improving the rate of HFpEF diagnosis.
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Okuno et al. (2025) conducted a review in Heart Failure with Preserved Ejection Fraction (HFpEF). 5-step diagnostic approach was evaluated. A novel 5-step diagnostic approach and the BREATH2 score can help clinicians identify unrecognized heart failure with preserved ejection fraction among individuals presenting with exertional dyspnea.
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