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H2FPEF Score for Heart Failure with Preserved Ejection Fraction
H2FPEF Score for Heart Failure with Preserved Ejection Fraction
Body mass index >30 kg/m2 (Heavy)
>=2 antihypertensive medications (Hypertensive)
Atrial fibrillation (paroxysmal or persistent)
Echo pulmonary artery systolic pressure >35 mmHg (Pulmonary hypertension)
Age >60 years (Elder)
Echo E/e' ratio >9 (Filling pressure)
Result0 points
Low probability of HFpEF.
- Probability category
- Low probability
When to use
- Evaluating unexplained exertional dyspnoea with a preserved ejection fraction to estimate the likelihood of HFpEF before invasive testing.
Formula
Weighted additive score (0-9): atrial fibrillation = 3, obesity (BMI >30) = 2, age >60 / >=2 antihypertensives / E/e' >9 / PASP >35 mmHg = 1 each. Score 0-1 = low, 2-5 = intermediate, 6-9 = high probability of HFpEF.
Pearls and pitfalls
- Derived against invasive exercise haemodynamics as the reference standard, outperforming prior expert-consensus algorithms.
- Intermediate scores (2-5) benefit most from further objective testing (exercise echo or invasive catheterisation).