Article Impact Level: HIGH Data Quality: STRONG Summary of Nature Medicine, 1–7. https://doi.org/10.1038/s41591-024-03140-1 Dr. Yogesh N. V. Reddy et al.
Points
- Researchers developed the HFpEF-ABA score to screen for heart failure with preserved ejection fraction (HFpEF) using only clinical variables: age, body mass index, and history of atrial fibrillation.
- The HFpEF-ABA score showed strong predictive power with an AUC of 0.839 in the initial derivation cohort of 414 individuals.
- Validation in an international cohort of 736 individuals yielded an AUC of 0.813, confirming the score’s robustness across diverse patient groups.
- Additional validations in specific cohorts (patients with unexplained dyspnea and heart failure hospitalization) demonstrated high AUC values of 0.840 and 0.929, respectively.
- The HFpEF-ABA score facilitates rapid and efficient screening for HFpEF, enabling earlier detection and appropriate resource allocation without immediate reliance on imaging data.
Summary
In response to the need for a more straightforward method to screen for heart failure with preserved ejection fraction (HFpEF) without relying on imaging data, researchers developed the HFpEF-ABA score. This new screening model uses only clinical variables: age, body mass index, and history of atrial fibrillation. In the initial derivation cohort of 414 individuals (249 women), the HFpEF-ABA score demonstrated strong predictive power with an area under the curve (AUC) of 0.839 (95% CI = 0.800–0.877, P < 0.0001), indicating good discrimination in identifying HFpEF probability.
The model’s robustness was further evidenced through validation in diverse patient cohorts. An international, multicenter cohort of 736 individuals (443 women) yielded an AUC of 0.813 (95% CI = 0.779–0.847, P < 0.0001), while additional validations included a cohort of 228 patients with unexplained dyspnea (136 women, AUC = 0.840, 95% CI = 0.782–0.900, P < 0.0001) and another cohort where heart failure hospitalization served as the HFpEF diagnostic criterion (456 individuals, 272 women, AUC = 0.929, 95% CI = 0.909–0.948, P < 0.0001). These validations across various settings confirm the score’s accuracy and reliability.
Utilizing the HFpEF-ABA score allows for rapid and efficient screening of patients presenting with dyspnea for undiagnosed HFpEF using readily available clinical data. This approach facilitates earlier detection and management of HFpEF and potentially guides the appropriate allocation of resources towards those most likely to benefit from further diagnostic evaluation, such as echocardiography. The findings suggest that this model could be instrumental in streamlining the diagnostic process in clinical settings, reducing the need for immediate imaging and aiding in the timely management of patients.
Link to the article: https://www.nature.com/articles/s41591-024-03140-1
References Reddy, Y. N. V., Carter, R. E., Sundaram, V., Kaye, D. M., Handoko, M. L., Tedford, R. J., Andersen, M. J., Sharma, K., Obokata, M., Verbrugge, F. H., & Borlaug, B. A. (2024). An evidence-based screening tool for heart failure with preserved ejection fraction: The HFpEF-ABA score. Nature Medicine, 1–7. https://doi.org/10.1038/s41591-024-03140-1
