A recent study co-authored by a cardiologist specializing in heart failure reveals a new scoring system that effectively identifies patients with Heart Failure with Preserved Ejection Fraction (HFpEF).
A groundbreaking study by a heart failure cardiologist from the University Hospitals Harrington Heart & Vascular Institute highlights the success of a newly created scoring system aimed at recognizing patients with Heart Failure with Preserved Ejection Fraction (HFpEF). The findings, titled “An Evidence-Based Screening Tool for Heart Failure with Preserved Ejection Fraction: The HFpEF-ABA Score,” were published in the July 12 edition of Nature Medicine.
In this research, Dr. Varun Sundaram, who holds multiple qualifications including MD, PhD, MSc, and FRCP (UK), serves as an Associate Professor at the Case Western Reserve University School of Medicine and leads the Advanced Heart Failure section at the Louis Stokes Cleveland Veteran Affairs Medical Center. Alongside heart failure researchers from institutions such as the Mayo Clinic, Johns Hopkins, Medical University of South Carolina, as well as partners in Belgium, Japan, Denmark, and Australia, he developed the HFpEF-ABA score. This score incorporates variables like age, body mass index (BMI), and presence of atrial fibrillation to facilitate HFpEF diagnosis. This tool could significantly change how we diagnose HFpEF, especially for patients experiencing unexplained shortness of breath, a major clinical concern.
With this easy-to-use scoring system, Dr. Sundaram explains, “We are able to screen and effectively identify patients with a high likelihood of HFpEF at the population level.” He adds, “This opens up new opportunities to enhance the standard of care and alters the diagnostic framework for improved recognition of HFpEF within communities.”
The HFpEF score was developed and validated using extensive data from major academic institutions across Australia, Belgium, Denmark, Japan, the Netherlands, and the United States, including Johns Hopkins Medicine, the Medical University of South Carolina, Mayo Clinic, and VA Medical Centers, with the largest cohort consisting of over 3,000 participants from the VA Medical Centers.
Diagnosing HFpEF at the community level can be quite complex and challenging, especially in primary care, due to the numerous factors involved in each patient’s condition. Many patients with HFpEF remain undiagnosed for long periods, often until their heart issues have worsened considerably.
The newly introduced HFpEF-ABA score allows clinicians to estimate the likelihood of HFpEF in patients based on three straightforward clinical factors: age, BMI, and atrial fibrillation. Importantly, this model does not require advanced imaging for initial evaluation, making it practical for use in various healthcare environments, including primary care and rural settings.
Patients who are determined to have a high likelihood of HFpEF can be directed toward further imaging tests such as echocardiograms and cardiac catheterization as necessary. Furthermore, these patients can begin treatment with newly approved medications for HFpEF, including SGLT-2 inhibitors and GLP-1 receptor agonists, in a timely fashion, enhancing their prognosis and long-term health outcomes.
“We are very optimistic about the clinical implications of this study,” Dr. Sundaram remarks. He emphasizes that using the new scoring system to screen for HFpEF is a simple and quick process that can be easily implemented by healthcare professionals in primary care or urgent care facilities.
In the United States, there are currently around six million individuals living with heart failure, a number projected to rise to eight million by 2030 due to an aging population and increasing obesity rates. At least half of these patients are expected to have HFpEF, the most rapidly growing type of heart failure, according to Dr. Sundaram. Early screening, diagnosis, and treatment for HFpEF are essential due to the differences in how it is managed compared to other forms of heart failure, allowing patients access to new and emerging therapies.
Dr. Sundaram stated, “By enhancing our ability to pinpoint these patients, healthcare providers can respond more swiftly and effectively to their specific needs.” He explains, “The new score was carefully designed to meet this requirement. It is an uncomplicated scoring tool that has shown excellent efficacy across diverse patient populations.”
Dr. Sundaram and his research team believe that a considerable share of the population is likely living with undiagnosed HFpEF. Future studies will concentrate on identifying optimal methods to motivate clinicians to implement the HFpEF-ABA scoring system. This will aid in the detection of patients with a high likelihood of HFpEF and guide them towards timely diagnosis and appropriate treatment, including new medication options that are now available.
