Screening for heart failure with preserved ejection fraction using the BREATH₂ score: diagnostic performance and...

Area of Science:

• Cardiology
• Primary Care Medicine
• Medical Diagnostics

Background:

• Heart failure with preserved ejection fraction (HFpEF) is increasingly common in aging populations.
• Diagnosing HFpEF in primary care presents significant challenges.
• The BREATH₂ score is a tool for HFpEF screening in Japanese primary care, but its wider applicability and prognostic value are not well-established.

Purpose of the Study:

• To assess the diagnostic accuracy of the BREATH₂ score for identifying HFpEF.
• To evaluate the prognostic capability of the BREATH₂ score concerning cardiac events.

Main Methods:

• A retrospective study of 234 patients (median age 73) with left ventricular ejection fraction ≥ 50%.
• HFpEF diagnosis was confirmed using the HFA-PEFF algorithm.
• Patients were stratified into low (≤3), intermediate (4-5), and high (≥6) risk groups based on BREATH₂ scores. Cardiac events included cardiac death or HF hospitalization.

Main Results:

• HFpEF prevalence increased with BREATH₂ score: 10.5% (low), 38.6% (intermediate), and 70.3% (high).
• The BREATH₂ score demonstrated superior diagnostic performance for HFpEF compared to the H₂FPEF score (AUC 0.81 vs. 0.69).
• Each 1-point increase in BREATH₂ score significantly elevated cardiac event risk (HR 1.94), independent of other scores. Kaplan-Meier analysis confirmed this trend.

Conclusions:

• The BREATH₂ score is associated with both HFpEF diagnosis and increased cardiac event risk.
• Findings suggest the BREATH₂ score holds potential as a valuable screening tool in primary care settings for HFpEF.