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Predictive Value of HFA-PEFF Score in Patients With Heart Failure With Preserved Ejection Fraction

Sun, Yuxi, Si, Jinping, Li, Jiaxin, Dai, Mengyuan, King, Emma, Zhang, Xinxin, Zhang, Yanli, Xia, Yunlong, Tse, Gary, Liu, Ying and others. (2021) Predictive Value of HFA-PEFF Score in Patients With Heart Failure With Preserved Ejection Fraction. Frontiers in Cardiovascular Medicine, 8 . Article Number 656536. ISSN 2297-055X. (doi:10.3389/fcvm.2021.656536) (KAR id:98317)


Aims: HFA-PEFF score has been proposed for diagnosing heart failure with preserved ejection fraction (HFpEF). Currently, there are only a limited number of tools for predicting the prognosis. In this study, we evaluated whether the HFA-PEFF score can predict mortality in patients with HFpEF.

Methods: This single-center, retrospective observational study enrolled patients diagnosed with HFpEF at the First Affiliated Hospital of Dalian Medical University between January 1, 2015, and April 30, 2018. The subjects were divided according to their HFA-PEFF score into low (0–2 points), intermediate (3–4 points), and high (5–6 points) score groups. The primary outcome was all-cause mortality.

Results: A total of 358 patients (mean age: 70.21 ± 8.64 years, 58.1% female) were included. Of these, 63 (17.6%), 156 (43.6%), and 139 (38.8%) were classified into the low, intermediate, and high score groups, respectively. Over a mean follow-up of 26.9 months, 46 patients (12.8%) died. The percentage of patients who died in the low, intermediate, and high score groups were 1 (1.6%), 18 (11.5%), and 27 (19.4%), respectively. A multivariate Cox regression identified HFA-PEFF score as an independent predictor of all-cause mortality [hazard ratio (HR):1.314, 95% CI: 1.013–1.705, P = 0.039]. A Cox analysis demonstrated a significantly higher rate of mortality in the intermediate (HR: 4.912, 95% CI 1.154–20.907, P = 0.031) and high score groups (HR: 5.291, 95% CI: 1.239–22.593, P = 0.024) than the low score group. A receiver operating characteristic (ROC) analysis indicated that the HFA-PEFF score can effectively predict all-cause mortality after adjusting for age and New York Heart Association (NYHA) class [area under the curve (AUC) 0.726, 95% CI 0.651–0.800, P = 0.000]. With an HFA-PEFF score cut-off value of 3.5, the sensitivity and specificity were 78.3 and 54.8%, respectively. The AUC on ROC analysis for the biomarker component of the score was similar to that of the total score.

Conclusions: The HFA-PEFF score can be used both to diagnose HFpEF and predict the prognosis. The higher scores are associated with higher all-cause mortality.

Item Type: Article
DOI/Identification number: 10.3389/fcvm.2021.656536
Uncontrolled keywords: predictive value, all-cause mortality, HFpEF, HFA-PEFF score, prognosis
Subjects: R Medicine
Divisions: Divisions > Division of Natural Sciences > Kent and Medway Medical School
Funders: National Natural Science Foundation of China (
Depositing User: Gary Tse
Date Deposited: 25 Nov 2022 09:39 UTC
Last Modified: 04 Mar 2024 15:30 UTC
Resource URI: (The current URI for this page, for reference purposes)

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