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Validation of heart failure algorithm for diagnosing heart failure with preserved ejection fraction: a meta-analysis
Shu Li1,2, Xiaomei Zhu2, Yunlong Zhang3
1Department of Emergency Medicine, Beijing Luhe Hospital, Capital Medical University, Beijing, China.
ESC Heart Failure
|June 9, 2023
Summary
The HFA-PEFF score effectively aids in diagnosing and excluding heart failure with preserved ejection fraction (HFpEF). This meta-analysis confirms its acceptable accuracy, though further research is recommended for robust validation.
Area of Science:
- Cardiology
- Diagnostic Accuracy
- Medical Informatics
Background:
- Heart failure with preserved ejection fraction (HFpEF) presents diagnostic challenges.
- The HFA-PEFF score offers a structured approach to HFpEF diagnosis.
- Comprehensive evaluation of the HFA-PEFF score's diagnostic utility is needed.
Approach:
- A systematic meta-analysis was conducted by searching PubMed, Web of Science, Cochrane Library, and Embase.
- Five studies involving 1521 participants were included to assess the HFA-PEFF score's performance.
- Pooled sensitivity, specificity, likelihood ratios, and diagnostic odds ratio were calculated for 'Rule-out' and 'Rule-in' strategies.
Key Points:
- The 'Rule-out' approach demonstrated high pooled sensitivity (0.98) and low negative likelihood ratio (0.05), suggesting effectiveness in excluding HFpEF.
- The 'Rule-in' approach showed good pooled specificity (0.87) and positive likelihood ratio (5.5), indicating utility in confirming HFpEF.
- The HFA-PEFF algorithm demonstrated acceptable diagnostic performance for both exclusion and inclusion of HFpEF.
Conclusions:
- The HFA-PEFF score is a valuable tool for the diagnosis and exclusion of HFpEF.
- The meta-analysis supports the clinical utility of the HFA-PEFF algorithm.
- Further studies are warranted to enhance the understanding of the HFA-PEFF score's diagnostic validity.
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