Why the study?
Disparities in patient pathways across the UK can lead to delayed diagnosis and treatment of HFpEF, motivating a consistent, clinically appropriate, and practical approach for reporting echocardiographic suspicion of HFpEF.
A UK-based Delphi consensus study established standardized statements for echocardiography reporting in HFpEF to help eliminate diagnostic delays.
Supports standardized echocardiography reporting to reduce HFpEF diagnostic delays; extends UK expert consensus toward guideline integration.
BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome in which signs and symptoms of heart failure (HF) occur despite a normal left ventricular ejection fraction. Transthoracic echocardiography (TTE) is the first-line imaging modality but disparities in patient pathways across the UK can lead to delayed diagnosis and treatment. We aimed to develop and validate a consistent, clinically appropriate and practical approach for reporting the echocardiographic suspicion of HFpEF. METHODS: scale, a survey including all statements was disseminated among a wider audience of healthcare professionals to determine agreement. A consensus threshold of 75% agreement was defined as 'strong' and ≥90% as 'very strong'. RESULTS: A total of 34 consensus statements were generated in seven domains: (1) challenges in the system approach to HFpEF; (2) enhancing referral for specialist review including echocardiography; (3) confidence in using a summary statement in an echo report; (4) identifying HFpEF and its underlying aetiology; (5) HF awareness, training and education; (6) refining multidisciplinary team roles in decision-making; (7) optimising patient experience.135 UK specialists experienced in managing HF participated in the survey, including physiologists/clinical scientists (n=43), HF specialist nurses (n=35), cardiologists (n=34), general practitioners (n=12), pharmacists (n=4) and others (n=7). 20 of 34 (59%) statements achieved very strong agreement, 10 of 34 (29%) achieved strong agreement and 4 of 34 (12%) did not meet the consensus threshold. CONCLUSIONS: Diagnosis of HFpEF requires access to essential diagnostic tools. Establishing standardised pathways for specialist assessment and referral, including TTE reporting of HFpEF, may help eliminate diagnostic delays and geographical disparities. Further education and awareness are crucial for improving detection rates, prompt referral and patient experience.
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Paton et al. (2025) studied Heart failure with preserved ejection fraction (HFpEF) (n=135). Delphi consensus on echocardiography reporting was evaluated on Agreement on consensus statements. A Delphi consensus survey of 135 UK heart failure specialists generated 34 statements on echocardiography reporting in HFpEF, with 88% achieving strong or very strong agreement.
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