Prognostic significance of the HFA-PEFF score in patients with heart failure with preserved ejection fraction

被引：33

作者：

Sotomi, Yohei ^{[1
]}

Iwakura, Katsuomi ^{[2
]}

Hikoso, Shungo ^{[1
]}

Inoue, Koichi ^{[2
]}

Onishi, Toshinari ^{[2
]}

Okada, Masato ^{[2
]}

Fujii, Kenshi ^{[2
]}

Okamura, Atsunori ^{[2
]}

Tamaki, Shunsuke ^{[3
]}

Yano, Masamichi ^{[4
]}

Hayashi, Takaharu ^{[5
]}

Nakagawa, Akito ^{[6
,7
]}

Nakagawa, Yusuke ^{[8
]}

Nakatani, Daisaku ^{[1
]}

Yasumura, Yoshio ^{[6
]}

Yamada, Takahisa ^{[3
]}

Sakata, Yasushi ^{[1
]}

机构：

[1] Osaka Univ, Dept Cardiovasc Med, Grad Sch Med, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan

[2] Sakurabashi Watanabe Hosp, Div Cardiol, Osaka, Japan

[3] Osaka Gen Med Ctr, Div Cardiol, Osaka, Japan

[4] Osaka Rosai Hosp, Div Cardiol, Osaka, Japan

[5] Osaka Police Hosp, Cardiovasc Div, Osaka, Japan

[6] Amagasaki Chuo Hosp, Div Cardiol, Amagasaki, Hyogo, Japan

[7] Osaka Univ, Dept Med Informat, Grad Sch Med, Osaka, Japan

[8] Kawanishi City Hosp, Div Cardiol, Kawanishi, Hyogo, Japan

来源：

ESC HEART FAILURE | 2021年 / 8卷 / 03期

关键词：

HFpEF; HFA-PEFF score; PREDICTION; MORTALITY; SURVIVAL;

D O I：

10.1002/ehf2.13302

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims The HFA-PEFF score is a part of the stepwise diagnostic algorithm of heart failure with preserved ejection fraction (HFpEF). We aimed to evaluate the prognostic significance of the HFA-PEFF score on the clinical outcomes in patients with HFpEF. Methods and results The Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with preserved Ejection Fraction (PURSUIT-HFpEF) study is a prospective, multicentre, observational study in which collaborating hospitals in Osaka record clinical, echocardiographic, and outcome data of patients with acute decompensated heart failure with preserved left ventricular ejection fraction (>= 50%) [UMIN-CTR ID: UMIN000021831]. Acute decompensated heart failure was diagnosed on the basis of the following criteria: (i) clinical symptoms and signs according to the Framingham Heart Study criteria; and (ii) serum N-terminal pro-B-type natriuretic peptide level of >= 400 pg/mL or brain natriuretic peptide level of >= 100 pg/mL. The HFA-PEFF score has functional, morphological, and biomarker domains. We evaluated the prognostic significance of the HFA-PEFF score (calculated based on the data at hospital discharge) on post-discharge clinical outcomes in this cohort. The primary endpoint of the present study was a composite of all-cause death and heart failure readmission. Between June 2016 and December 2019, 871 patients were enrolled from 26 hospitals (mean follow-up duration 399 +/- 349 days). A total of 804 patients were finally analysed after excluding patients with scores of 0 (N = 5) and 1 (N = 15) from 824 patients with available HFA-PEFF score based on the echocardiographic and laboratory data at discharge. According to the laboratory and echocardiographic data at the time of discharge, 487 patients (59.1%) were diagnosed as HFpEF (HFA-PEFF score >= 5) while 317 patients (38.5%) had intermediate score. Kaplan-Meier analysis divided by the HFA-PEFF score [low, score 2-5 (N = 494) vs. high, score 6 (N = 310)] indicated that the HFA-PEFF score successfully stratified the patients for the primary endpoint (log-rank test P < 0.001). Cox proportional hazard model showed that the HFA-PEFF score was significantly associated with the primary endpoint (high score with reference to low score, adjusted hazard ratio 1.446, 95% confidence interval [1.099-1.902], P = 0.008). Conclusion The HFA-PEFF score at discharge was significantly associated with the post-discharge clinical outcomes in acute decompensated heart failure patients with preserved ejection fraction. This study suggested clinical usefulness of the HFA-PEFF score not only as a diagnostic tool but also a practical prognostic tool.

引用

页码：2154 / 2164

页数：11

共 24 条

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