Combination of SVI/S′ and diagnostic scores for heart failure with preserved ejection fraction

医学 心脏病学 内科学 心力衰竭 肺楔压 射血分数 射血分数保留的心力衰竭 冲程容积 接收机工作特性
作者
Guanyu Mu,Weiding Wang,Changle Liu,Juan Xie,Hao Zhang,Xiaowei Zhang,Jingjin Che,Gary Tse,Tong Liu,Guangping Li,Huaying Fu,Kang‐Yin Chen
出处
期刊:Clinical and Experimental Pharmacology and Physiology [Wiley]
卷期号:50 (8): 677-687 被引量:3
标识
DOI:10.1111/1440-1681.13782
摘要

Abstract The diagnosis of heart failure with preserved ejection fraction (HFpEF) remains a challenge. There are three methods proposed as diagnostic tools. H 2 FPEF score was determined by six weighted clinical characteristics and echocardiographic variables. Heart Failure Association (HFA)‐PEFF algorithm consists of various functional and morphological variables as well as natriuretic peptides. SVI/S′ is a novel echocardiographic parameter calculated by stroke volume index and mitral annulus systolic peak velocity. This study aimed to compare the three approaches in patients with suspected HFpEF. Patients referred to right heart catheterization for suspected HFpEF were classified into low‐, intermediate‐ and high‐likelihood groups according to H 2 FPEF or HFA‐PEFF scores. A diagnosis of HFpEF was confirmed by pulmonary capillary wedge pressure (PCWP) of ≥15 mm Hg according to the guidelines. In result, a total of 128 patients were included. Of these, 71 patients with PCWP ≥15 mm Hg and 57 patients with PCWP <15 mm Hg. Moderate correlations were observed between H 2 FPEF score, HFA‐PEFF score, SVI/S′ and PCWP. The area under curve of SVI/S′ was 0.82 for diagnosis of HFpEF, compared with 0.67 for H 2 FPEF score and 0.75 for HFA‐PEFF score by receiver‐operating characteristics analysis. Combining SVI/S′ with diagnostic scores showed higher Youden index and accuracy than each score alone. Kaplan–Meier analysis reported that the high‐likelihood group showed poorer outcomes regardless the method used for diagnosis. Among the contemporary tools for identifying HFpEF in this study, the combination of SVI/S′ with risk scores showed best diagnostic ability. Each of the strategies can determine rehospitalisation because of heart failure.
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