Candidate Screening for Heart Failure With Preserved Ejection Fraction Clinic by Fib-4 Index From Subclinical...

Area of Science:

• Cardiology
• Hepatology
• Public Health Screening

Background:

• Early detection of heart failure with preserved ejection fraction (HFpEF) is challenging in mass screenings.
• The fibrosis-4 (Fib-4) index, a non-invasive marker of liver fibrosis, has not been widely explored as a potential screening tool for HFpEF.

Purpose of the Study:

• To investigate the utility of the Fib-4 index as a screening tool for identifying individuals at high risk for HFpEF.
• To assess the correlation between the Fib-4 index and HFpEF risk stratification.
• To determine if the Fib-4 index can predict clinical outcomes in a subclinical population.

Main Methods:

• A cohort of 710 individuals without prior cardiovascular disease and preserved ejection fraction (EF ≥ 50%) from annual health checks (2006-2007) were analyzed.
• Participants were stratified into HFpEF risk groups using the Heart Failure Association-PEFF (HFA-PEFF) score.
• The Fib-4 index was calculated and correlated with HFA-PEFF scores and clinical outcomes.

Main Results:

• The highest HFpEF risk group (HFA-PEFF score 4-6) exhibited a significantly poorer prognosis regarding all-cause mortality and heart failure hospitalization.
• The Fib-4 index showed a significant correlation with HFpEF risk stratification (r_s = 0.526).
• Elevated Fib-4 index levels were independently associated with higher HFpEF risk and predicted adverse clinical events, including mortality and HF hospitalization.

Conclusions:

• The Fib-4 index serves as a valuable tool for selecting individuals who require further specialized examination for HFpEF within a subclinical population.
• This non-invasive marker offers a promising approach for improving early detection and risk stratification of HFpEF in community settings.