Key result
Only 37% of discharged HFpEF patients meet ESC criteria, revealing significant diagnostic dissonance in practice.
Why the study?
The study aimed to assess the proportion of patients diagnosed with HFpEF in clinical practice who maintain this diagnosis when evaluated against ESC 2016 guidelines, Russian 2017 guidelines, and the H2FPEF score.
Observational (n=42)
No
Absolute Event Rate: 37% vs 80%
There is significant discordance in the clinical diagnosis of HFpEF depending on the guideline criteria applied, particularly driven by NT-proBNP requirements.
Discordant HFpEF criteria may cause inconsistent diagnoses in practice; leaves open the need for harmonized standards in research.
This pilot study was aimed to assess the percentage of patients admitted to a Russian hospital and diagnosed with heart failure with preserved ejection fraction (HFpEF) maintaining this diagnosis when evaluated against the ESC 2016 and Russian 2017 heart failure guidelines. In addition, we reviewed the probability of an HFpEF diagnosis when patients were assessed against the H2FPEF score. Forty-two patients (mean age 68 ±7,5) diagnosed with HFpEF on their discharge record, admitted between March 2018 and May 2018, were included. Twenty percent of patients did not meet Russian guideline criteria for HFpEF due to either the absence of symptoms and/or echocardiographic evidence of structural/functional abnormalities. Using the ESC 2016 guidelines (which required an elevation in NT Pro BNP) the diagnosis was confirmed in only 37% of patients, mostly due to the normal level of NTproBNP in 54.8% of those investigated. The probability of HFpEF by H2FPEF score in patients with dyspnea and HFpEF by ESC 2016 criteria was 93% and without HFpEF by ESC 2016 criteria 68% (p = 0.054). In contrast, the probability of HFpEF by H2FPEF score in patients with dyspnea and HFpEF by Russian criteria was 84.4%.
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Mareev et al. (2020) conducted an observational in Heart failure with preserved ejection fraction (HFpEF) (n=42). ESC 2016 and Russian 2017 heart failure guidelines vs. Clinical discharge diagnosis was evaluated on Confirmation of HFpEF diagnosis. Evaluation of patients discharged with HFpEF showed that only 37% met ESC 2016 criteria and 80% met Russian 2017 criteria, demonstrating significant diagnostic dissonance in clinical practice.
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