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Prognostic Impact of Modified H2FPEF Score in Patients Receiving Trans-Catheter Aortic Valve Replacement

Background: H2FPEF is a recently introduced score for the diagnosis of heart failure with preserved ejection fraction (HFpEF). Many patients with severe aortic stenosis have clinical/subclinical HFpEF and have worsening heart failure even after trans-catheter aortic valve replacement (TAVR). We inve...

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Autores principales: Akao, Kousuke, Imamura, Teruhiko, Tanaka, Shuhei, Onoda, Hiroshi, Ushijima, Ryuichi, Sobajima, Mitsuo, Fukuda, Nobuyuki, Ueno, Hiroshi, Kinugawa, Koichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455783/
https://www.ncbi.nlm.nih.gov/pubmed/37629434
http://dx.doi.org/10.3390/jcm12165396
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author Akao, Kousuke
Imamura, Teruhiko
Tanaka, Shuhei
Onoda, Hiroshi
Ushijima, Ryuichi
Sobajima, Mitsuo
Fukuda, Nobuyuki
Ueno, Hiroshi
Kinugawa, Koichiro
author_facet Akao, Kousuke
Imamura, Teruhiko
Tanaka, Shuhei
Onoda, Hiroshi
Ushijima, Ryuichi
Sobajima, Mitsuo
Fukuda, Nobuyuki
Ueno, Hiroshi
Kinugawa, Koichiro
author_sort Akao, Kousuke
collection PubMed
description Background: H2FPEF is a recently introduced score for the diagnosis of heart failure with preserved ejection fraction (HFpEF). Many patients with severe aortic stenosis have clinical/subclinical HFpEF and have worsening heart failure even after trans-catheter aortic valve replacement (TAVR). We investigated the prognostic impact of the H2FPEF score in TAVR candidates. Methods: Patients undergoing TAVR procedures at a single academic center between 2015 and 2022 were included. The H2FPEF score was calculated using baseline characteristics before TAVR. The prognostic impact of the score on the post-TAVR composite endpoint, consisting of all-cause death and heart failure readmissions during the 2-year observation period, was evaluated. Results: A total of 244 patients (median age 86 years, 70 males) were included. The median value of H2FPEF score was 3 (2, 4). The score was significantly associated with the primary outcome with a hazard ratio of 1.33 (95% confidence interval 1.02–1.74, p = 0.036). We constructed a modified H2FPEF score by adjusting cutoffs of several items for better prognostic stratification (i.e., age and body mass index). A modified score had a higher area under the curve than the original one (0.65 vs. 0.59, p = 0.028) and was independently associated with the primary outcome with an adjusted hazard ratio of 1.22 (95% confidence interval 1.01–1.49, p = 0.047). Conclusions: A modified H2FPEF score, which was originally developed to diagnose the presence of HFpEF, could be used to risk-stratify elderly patients receiving TAVR. The clinical utility of this score should be validated in future studies.
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spelling pubmed-104557832023-08-26 Prognostic Impact of Modified H2FPEF Score in Patients Receiving Trans-Catheter Aortic Valve Replacement Akao, Kousuke Imamura, Teruhiko Tanaka, Shuhei Onoda, Hiroshi Ushijima, Ryuichi Sobajima, Mitsuo Fukuda, Nobuyuki Ueno, Hiroshi Kinugawa, Koichiro J Clin Med Article Background: H2FPEF is a recently introduced score for the diagnosis of heart failure with preserved ejection fraction (HFpEF). Many patients with severe aortic stenosis have clinical/subclinical HFpEF and have worsening heart failure even after trans-catheter aortic valve replacement (TAVR). We investigated the prognostic impact of the H2FPEF score in TAVR candidates. Methods: Patients undergoing TAVR procedures at a single academic center between 2015 and 2022 were included. The H2FPEF score was calculated using baseline characteristics before TAVR. The prognostic impact of the score on the post-TAVR composite endpoint, consisting of all-cause death and heart failure readmissions during the 2-year observation period, was evaluated. Results: A total of 244 patients (median age 86 years, 70 males) were included. The median value of H2FPEF score was 3 (2, 4). The score was significantly associated with the primary outcome with a hazard ratio of 1.33 (95% confidence interval 1.02–1.74, p = 0.036). We constructed a modified H2FPEF score by adjusting cutoffs of several items for better prognostic stratification (i.e., age and body mass index). A modified score had a higher area under the curve than the original one (0.65 vs. 0.59, p = 0.028) and was independently associated with the primary outcome with an adjusted hazard ratio of 1.22 (95% confidence interval 1.01–1.49, p = 0.047). Conclusions: A modified H2FPEF score, which was originally developed to diagnose the presence of HFpEF, could be used to risk-stratify elderly patients receiving TAVR. The clinical utility of this score should be validated in future studies. MDPI 2023-08-19 /pmc/articles/PMC10455783/ /pubmed/37629434 http://dx.doi.org/10.3390/jcm12165396 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Akao, Kousuke
Imamura, Teruhiko
Tanaka, Shuhei
Onoda, Hiroshi
Ushijima, Ryuichi
Sobajima, Mitsuo
Fukuda, Nobuyuki
Ueno, Hiroshi
Kinugawa, Koichiro
Prognostic Impact of Modified H2FPEF Score in Patients Receiving Trans-Catheter Aortic Valve Replacement
title Prognostic Impact of Modified H2FPEF Score in Patients Receiving Trans-Catheter Aortic Valve Replacement
title_full Prognostic Impact of Modified H2FPEF Score in Patients Receiving Trans-Catheter Aortic Valve Replacement
title_fullStr Prognostic Impact of Modified H2FPEF Score in Patients Receiving Trans-Catheter Aortic Valve Replacement
title_full_unstemmed Prognostic Impact of Modified H2FPEF Score in Patients Receiving Trans-Catheter Aortic Valve Replacement
title_short Prognostic Impact of Modified H2FPEF Score in Patients Receiving Trans-Catheter Aortic Valve Replacement
title_sort prognostic impact of modified h2fpef score in patients receiving trans-catheter aortic valve replacement
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455783/
https://www.ncbi.nlm.nih.gov/pubmed/37629434
http://dx.doi.org/10.3390/jcm12165396
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