A scoring system for diagnosing heart failure with preserved ejection fraction based on exercise echocardiography

Area of Science:

• Cardiology
• Echocardiography
• Heart Failure Research

Background:

• Heart failure with preserved ejection fraction (HFpEF) diagnosis in dyspneic patients remains challenging.
• Current diagnostic criteria for HFpEF using exercise stress echocardiography (ESE) lack standardization.
• There is a need for reliable ESE-based criteria to identify HFpEF.

Purpose of the Study:

• To develop and validate novel ESE-based criteria for diagnosing HFpEF in patients presenting with dyspnea.
• To create a scoring system utilizing specific echocardiographic parameters.
• To assess the diagnostic and prognostic capabilities of the developed ESE score.

Main Methods:

• Retrospective evaluation of 81 patients with dyspnea undergoing ESE and invasive hemodynamics.
• Logistic regression analysis to identify independent predictors of HFpEF.
• Development of a weighted ESE score based on resting left atrial reservoir strain, exercise septal E/e' ratio, and ultrasound B-lines.

Main Results:

• The ESE score, incorporating three key echocardiographic variables, demonstrated high accuracy in diagnosing HFpEF (AUC 0.90).
• The ESE score outperformed existing ASE/ESCVI criteria in diagnostic ability.
• A higher ESE score was significantly associated with increased risk of mortality or worsening HF events.

Conclusions:

• The developed ESE score is an effective tool for diagnosing HFpEF in dyspneic patients using exercise echocardiography.
• The ESE score provides valuable prognostic information regarding adverse cardiovascular outcomes.
• This standardized approach may improve HFpEF diagnosis and patient management.