H2FPEF Score for Heart Failure with Preserved Ejection Fraction
H2FPEF Calculator
H₂ - Heavy (BMI >30 kg/m²)
H₂ - Hypertensive (≥2 Antihypertensives)
F - Atrial Fibrillation
P - Pulmonary Hypertension (PASP >35 mmHg)
E - Elder (Age >60)
F - Filling Pressure (E/e' >9)
H2FPEF Score:
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Estimates probability of underlying heart failure in patients with preserved ejection fraction on echo.
Why Use
HFpEF is difficult to diagnose, and historical diagnostic criteria have been consensus-based. This score offers an evidence-based way to identify patients likely to have HFpEF.
When to Use
Use in euvolemic patients with unexplained exertional dyspnea who have had an echo, to assess for heart failure with preserved ejection fraction (HFpEF).
Formula
Probability of heart failure with preserved EF = (Z / (1 + Z)) x 100 where Z = e y and y = -9.1917 + 0.0451 x age + 0.1307 x BMI + 0.0859 x E/e' ratio + 0.0520 x pulmonary artery systolic pressure + 1.6997 x atrial fibrillation (1 for Yes and 0 for No) Note: the authors describe two prediction models in the study , one involving simple addition of points and dichotomous variables, and one with continuous variables. The latter was found to be more accurate and so is presented here. Hypertension was included in the simple model but not found to be significant in the complex model and therefore is excluded.
Advice
Consider alternate causes of dyspnea if low probability, and consider emperic treatment for HFpEF if high probability. For intermediate probability patients additional testing.