HFA-PEFF Diagnostic Algorithm

HFA-PEFF Diagnostic Algorithm

Assists in diagnosing HFpEF in symptomatic patients.

HFA-PEFF Diagnostic Algorithm

Diagnostic algorithm for heart failure with preserved ejection fraction (HFpEF) using functional, morphological, and biomarker domains.

Laboratory Values

Comorbidities

Atrial Fibrillation

History of atrial fibrillation

Diabetes

History of diabetes mellitus

Hypertension

History of hypertension

Coronary Artery Disease

History of coronary artery disease

Obesity

BMI ≥ 30 kg/m²

COPD

History of chronic obstructive pulmonary disease

Sleep Apnea

History of sleep apnea

Anemia

History of anemia

Renal Dysfunction

History of renal dysfunction

Scoring System

Functional Domain (0-2 points):
  • EF 50-59%: 1 point
  • EF ≥60%: 2 points
Morphological Domain (0-2 points):
  • Hypertension: 1 point
  • Obesity (BMI ≥30): 1 point
  • Atrial fibrillation: 1 point
Biomarker Domain (0-2 points):
  • NT-proBNP 125-365 pg/mL: 1 point
  • NT-proBNP ≥365 pg/mL: 2 points
  • BNP 35-125 pg/mL: 1 point
  • BNP ≥125 pg/mL: 2 points
Diagnosis:
  • ≥5 points: HFpEF (high probability)
  • 2-4 points: HFpEF (intermediate probability)
  • 0-1 points: Unlikely HFpEF

References

  • Pieske, B., Tschöpe, C., de Boer, R. A., Fraser, A. G., Anker, S. D., Donal, E., ... & Paulus, W. J. (2019). How to diagnose heart failure with preserved ejection fraction: the HFA-PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). European heart journal, 40(40), 3297-3317.
  • Redfield, M. M., Borlaug, B. A., & Lewis, G. D. (2018). Heart failure with preserved ejection fraction: a review. JAMA, 320(1), 1-2.
  • Yancy, C. W., Jessup, M., Bozkurt, B., Butler, J., Casey, D. E., Colvin, M. M., ... & Westlake, C. (2017). 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. Journal of the American College of Cardiology, 70(6), 776-803.
  • Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G., Coats, A. J., ... & van der Meer, P. (2016). 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) developed with the special contribution of the Heart Failure Association (HFA) of the ESC. European heart journal, 37(27), 2129-2200.

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