HFA-PEFF和H2FPEF评分在确定保留射血分数的心力衰竭的表型和合并症负担中的价值

IF 1.3 4区 医学 Q4 PHYSIOLOGY
Selda Murat, Bektas Murat, Halit Emre Yalvac, Fatih Enes Durmaz, Duygu Inan, Ahmet Celik, Yuksel Cavusoglu
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引用次数: 0

摘要

HFA-PEFF和H2FPEF评分被广泛用于诊断保留射血分数(HFpEF)心力衰竭。然而,HFpEF是一种异质性疾病,具有多种表型,受合并症和病因的影响。本研究旨在评估这些评分系统在不同HFpEF表型中的表现和一致性,并确定可能改善表型的其他超声心动图和临床参数。方法将194例HFpEF患者分为3种表型:(1)普通代谢组,(2)心房颤动(AF)为主组,(3)高血压合并左室肥厚组。分析了这些表型的临床、实验室和超声心动图特征。评估HFA-PEFF和H2FPEF评分在HFpEF患者表型上的一致性和表现。结果共纳入194例HFpEF患者。92.3%的患者有高HFA-PEFF评分,只有42.8%的患者有高H2FPEF评分。这些评分方法之间的一致性在所有表型中都很低。表型特异性差异:表型3的室间隔厚度最高,表型2的肺动脉收缩压(SPAP)最高,表型2的左心房储层应变(LASr)和右心室自由壁纵向应变(RV-FWLS)最低。结论HFA-PEFF和H2FPEF评分在区分HFpEF表型方面一致性有限。其他超声心动图参数如IVS厚度、SPAP、LASr和RV-FWLS可能会增强表型分化并改善HFpEF的分类。结合这些参数的更精细的诊断方法可以指导个性化的治疗策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The value of the HFA-PEFF and H2FPEF scores in determining the phenotypes and comorbidity burden in heart failure with preserved ejection fraction

Background

The HFA-PEFF and H2FPEF scores are widely used for diagnosing heart failure with preserved ejection fraction (HFpEF). However, HFpEF is a heterogeneous condition with multiple phenotypes influenced by comorbidities and etiologies.

Objectives

This study aimed to evaluate the performance and agreement of these scoring systems across different HFpEF phenotypes and identify additional echocardiographic and clinical parameters that may improve phenotyping.

Methods

A total of 194 HFpEF patients were classified into three phenotypes: (1) common metabolic group, (2) atrial fibrillation (AF)-predominant group, and (3) hypertension with left ventricular hypertrophy group. The clinical, laboratory, and echocardiographic characteristics of these phenotypes were analyzed. The agreement and performance between HFA-PEFF and H2FPEF scores for phenotypes in HFpEF patients were assessed.

Results

A total of 194 HFpEF patients were included. While 92.3% of patients had a high HFA-PEFF score, only 42.8% had a high H2FPEF score. The agreement between these scoring methods was low across all phenotypes. Phenotype-specific differences were observed: interventricular septal thickness was highest in phenotype 3, systolic pulmonary artery pressure (SPAP) was highest in phenotype 2, and left atrial reservoir strain (LASr) and right ventricular free wall longitudinal strain (RV-FWLS) were lowest in phenotype 2.

Conclusion

The HFA-PEFF and H2FPEF scores showed limited agreement in distinguishing HFpEF phenotypes. Additional echocardiographic parameters such as IVS thickness, SPAP, LASr, and RV-FWLS may enhance phenotypic differentiation and improve HFpEF classification. A more refined diagnostic approach incorporating these parameters could guide personalized treatment strategies.

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来源期刊
CiteScore
3.40
自引率
5.60%
发文量
62
审稿时长
6-12 weeks
期刊介绍: Clinical Physiology and Functional Imaging publishes reports on clinical and experimental research pertinent to human physiology in health and disease. The scope of the Journal is very broad, covering all aspects of the regulatory system in the cardiovascular, renal and pulmonary systems with special emphasis on methodological aspects. The focus for the journal is, however, work that has potential clinical relevance. The Journal also features review articles on recent front-line research within these fields of interest. Covered by the major abstracting services including Current Contents and Science Citation Index, Clinical Physiology and Functional Imaging plays an important role in providing effective and productive communication among clinical physiologists world-wide.
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