Two-Step Strategy Simplifies HFpEF Diagnosis with High Accuracy
Two-Step Strategy Simplifies HFpEF Diagnosis with High Accuracy
Published: June 9, 2025
1. Topline Finding
• A simplified two-step approach using left atrial volume indexed by height² (LAViH²) and natriuretic peptides (NP) accurately identifies HFpEF and helps avoid unnecessary testing in many patients.
• Yields 88% specificity and 97% positive predictive value, reducing need for additional testing.
2. How It Works
• Step 1: Measure LAViH2 via echocardiography (cut-off >35.5 mL/m² in sinus rhythm, >38.6 in AF).
• Step 2: Check NP levels based on HFA-PEFF major criteria.
• If both are abnormal, HFpEF can be “ruled in” with high confidence.
3. Clinical Impact
• Identified 60% of HFpEF patients accurately in derivation cohort; validation cohorts showed similar accuracy.
• Reduced intermediate diagnostic classifications (HFA-PEFF / H2FPEF) by 21%–57%.
• Approach is flexible—LA reservoir strain may be used as an alternative to volume.
4. In Practice
• The method can serve as a first step before using full scoring systems like HFA-PEFF or H₂FPEF, saving time and resources.
