Key result
HFpEF risk scores show wide variability in breast cancer, classifying up to ~42% as intermediate-high risk.
Why the study?
HFpEF is an emerging, under-recognized condition in breast cancer patients potentially present prior to cancer therapy, but baseline probability and longitudinal evolution remained uncharacterized.
Cohort (n=145)
No
Validated HFpEF probability scoring systems show substantial heterogeneity and limited agreement in breast cancer patients prior to cardiotoxic therapy, suggesting they may not be directly interchangeable in cardio-oncology.
Answers are grounded in this paper and cite their sources.
HFpEF scoring systems warrant caution in breast cancer patients due to heterogeneity; leaves open which algorithm best predicts outcomes in cardio-oncology.
Background: Breast cancer patients are exposed to cardiovascular complications related to both pre-existing cardiovascular risk factors and cardiotoxic cancer therapies. Heart failure with preserved ejection fraction (HFpEF) is an emerging and often under-recognized condition in this population, potentially present before treatment initiation and further influenced by oncologic therapies. This study aimed to characterize baseline HFpEF probability and its longitudinal evolution using validated scoring systems in a real-world cardio-oncology cohort. Methods: We retrospectively evaluated 145 women with breast cancer undergoing baseline cardio-oncology assessment before initiation of potentially cardiotoxic therapies. HFpEF probability was estimated using three validated algorithms (H2FPEF, ABA, and HFA-PEFF). A subgroup of 89 patients underwent exploratory reassessment after 12 ± 3 months to investigate longitudinal changes in HFpEF probability according to treatment. Results: At baseline, HFpEF probability varied substantially according to the scoring system applied, with 14.8–41.5% of patients classified as having intermediate-to-high probability. Agreement among the three algorithms was limited, particularly between HFA-PEFF and H2FPEF/ABA scores. Exploratory longitudinal analyses showed no significant changes in HFpEF probability categories during follow-up. Conclusions: HFpEF probability assessment in breast cancer patients showed substantial baseline heterogeneity across validated scoring systems, with clinically relevant differences in risk classification and limited inter-score agreement. These findings provide novel insights into an underexplored cardio-oncology phenotype and suggest that currently available HFpEF scoring systems may not be directly interchangeable in this clinical setting. Prospective studies including provocative testing are needed to determine the clinical relevance of HFpEF probability scores in breast cancer patients.
No takes yet. Share an insight, caveat, or question.
Battistoni et al. (2026) conducted a cohort in Breast cancer (n=145). Breast cancer prior to cardiotoxic therapy was evaluated on Baseline HFpEF probability (intermediate-to-high). Baseline HFpEF probability assessment in women with breast cancer showed substantial heterogeneity across validated scoring systems, with 14.8% to 41.5% of patients classified as having intermediate-to-high probability.
Synapse has enriched 10 related papers. Consider them for comparative context: