Evaluating the Prognostic Value of the Modified H2FPEF Score in Patients With Heart Failure With Preserved Ejection Fraction.

IF 1.4 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiology Research Pub Date : 2024-10-01 Epub Date: 2024-09-16 DOI:10.14740/cr1635
Ya Qiong Jin, Lu Geng, Yue Li, Ke Ke Wang, Bing Xiao, Meng Xiao Wang, Xue Ying Gao, Jie Zhang, Xiu Chun Yang, Jing Chao Lu
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Abstract

Background: The H2FPEF score, a convenient tool developed for diagnosing heart failure with preserved ejection fraction (HFpEF), exhibited useful prognostic utility in HFpEF. However, the applicability and the prognostic value of the H2FPEF score in Chinese HFpEF patients have yet to be fully confirmed. The study aimed to evaluate the effect of modified H2FPEF score on the prognosis of Chinese HFpEF patients.

Methods: In this retrospective study, we calculated the H2FPEF scores by body mass index (BMI) ≥ 25 kg/m2 and 30 kg/m2 respectively, for 497 consecutive HFpEF patients in China. Subjects were divided into low- (0 - 3 points), intermediate- (4 - 6 points), and high-score (7 - 9 points) groups. The primary and secondary endpoints were heart failure (HF)-related events and acute coronary syndrome (ACS), respectively. Cox proportional hazard models were applied to calculate hazard ratios (HRs). Receiver operating characteristic (ROC) curves and areas under the curve (AUC) were used to evaluate the prediction of the H2FPEF score for adverse outcomes.

Results: Over a mean follow-up of 40.46 ± 6.52 months, the primary and secondary endpoints occurred in 168 patients (33.8%) and 97 patients (19.5%), respectively. By the definition of obesity as BMI ≥ 25 kg/m2, a higher incidence of HF-related events and ACS was observed among those with a higher modified H2FPEF score. The modified H2FPEF significantly predicted HF-related events (AUC: 0.723; 95% confidence interval (CI): 0.676 - 0.770; P < 0.001) and ACS (AUC: 0.670; 95% CI: 0.608 - 0.731; P < 0.014) with higher power than the H2FPEF score calculated by BMI ≥ 30 kg/m2. The cutoff of the modified H2FPEF score was 6.5 for detecting HF-related events and ACS.

Conclusions: The modified H2FPEF score, using BMI ≥ 25 kg/m2 to define obesity, could more effectively predict the occurrence of subsequent cardiovascular events in Chinese HFpEF patients. The modified H2FPEF score above 6.5 is a risk factor for adverse cardiovascular events in HFpEF patients.

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评估改良 H2FPEF 评分对射血分数保留型心力衰竭患者的预后价值
背景H2FPEF 评分是一种用于诊断射血分数保留型心力衰竭(HFpEF)的简便工具,对 HFpEF 的预后具有实用价值。然而,H2FPEF 评分在中国 HFpEF 患者中的适用性和预后价值尚未得到充分证实。本研究旨在评估改良后的H2FPEF评分对中国HFpEF患者预后的影响:在这项回顾性研究中,我们按照体重指数(BMI)≥25 kg/m2和30 kg/m2分别计算了497名中国连续HFpEF患者的H2FPEF评分。受试者被分为低分(0 - 3 分)、中分(4 - 6 分)和高分(7 - 9 分)组。主要和次要终点分别为心衰(HF)相关事件和急性冠状动脉综合征(ACS)。采用 Cox 比例危险模型计算危险比(HRs)。接收者操作特征曲线(ROC)和曲线下面积(AUC)用于评估H2FPEF评分对不良后果的预测:在平均 40.46 ± 6.52 个月的随访期间,分别有 168 名患者(33.8%)和 97 名患者(19.5%)出现主要和次要终点。肥胖的定义是体重指数(BMI)≥ 25 kg/m2,在改良 H2FPEF 评分较高的患者中观察到较高的心房颤动相关事件和 ACS 发生率。改良 H2FPEF 能显著预测心房颤动相关事件(AUC:AUC:0.723;95% 置信区间 (CI):0.676 - 0.770;P < 0.001)和 ACS(AUC:0.670;95% CI:0.608 - 0.731;P < 0.014),预测能力高于按体重指数≥ 30 kg/m2 计算的 H2FPEF 评分。修改后的 H2FPEF 评分的临界值为 6.5,可用于检测 HF 相关事件和 ACS:结论:以体重指数≥25 kg/m2定义肥胖的改良H2FPEF评分能更有效地预测中国HFpEF患者后续心血管事件的发生。修改后的H2FPEF评分超过6.5分是HFpEF患者发生不良心血管事件的风险因素。
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来源期刊
Cardiology Research
Cardiology Research CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.50
自引率
0.00%
发文量
42
期刊介绍: Cardiology Research is an open access, peer-reviewed, international journal. All submissions relating to basic research and clinical practice of cardiology and cardiovascular medicine are in this journal''s scope. This journal focuses on publishing original research and observations in all cardiovascular medicine aspects. Manuscript types include original article, review, case report, short communication, book review, letter to the editor.
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