H₂FPEF Score Predicts 1-year Rehospitalisation Of Patients With Heart Failure With Preserved Ejection Fraction

[Background and objective]Heart failure with preserved ejection fraction(HFpEF)is a type of heart failure(HF).In recent years,HFpEF has received widespread attention and became the most common form of HF.However,there is currently a lack of valuable predictors for the prognosis of this disease.Lately,the H2FPEF score which consists of six clinical and echocardiographic variables has been proposed for the discrimination of HFpEF from non-cardiac causes of dyspnoea.Here,we aimed to identify a non-invasive scoring system that can effectively predict 1-year rehospitalisation for patients with HFpEF.[Methods]In this prospective cohort study,after exclusion of 49 from 200 consecutive patients with HFpEF in the Soochow University who were enrolled between April 2016 and December 2018,the remaining 151 patients(81 men,70 women)were eligible for the analysis.We recorded each patient’s medical history,relevant clinical characteristics and calculated the H2FPEF score(0-9points).The primary end points were readmission for HF and all-cause mortality within 1 year.We investigated the association between H2FPEF score and 1-year readmission for heart failure using multivariate Cox regression analysis.Three completely agnostic models(support-vector machine,decision tree in R and Cox regression analysis)were generated,and the areas under the receiver-operating characteristic curve(AUCs)were compared.[Results]In all of the 151 patients with HFpEF,the mean H2FPEF score was 4.8±1.8,and 75 readmitted to hospital for HF within 1 year.Kaplan-Meier survival curves showed a significantly higher probability of 1-year rehospitalisation in the patients with a high H2FPEF score(P<0.001).Multivariate Cox regression analysis indicated that obesity,age>70 years,treatment with≥2 antihypertensives,echocardiographic E/e’ ratio>9 and pulmonary artery pressure>35mmHg were independent predictors of 1-year readmission for patients with HFpEF(P<0.05).Three models(support vector machine,decision tree in R and Cox regression analysis)proved that H2FPEF score could effectively predict 1-year readmission for patients with HFpEF(area under the curve,0.910,0.899 and 0.771,respectively;p<0.001).[Conclusion]1.The H2FPEF score has excellent predictive value for 1-year rehospitalisation of patients with HFpEF.2.The higher the H2FPEF score for patients with HFpEF,the more likely they are to be rehospitalized within 1 year.