This systematic review looked at the strengths and limitations of HFpEF probability scores, specifically the HFA-PEFF and H2FPEF tools. These tools are used to estimate the likelihood of heart failure with preserved ejection fraction in patients, including those with atrial fibrillation or obesity. The review analyzed how well these scores perform across different patient profiles to support precision medicine strategies.
The main findings indicate that both HFA-PEFF and H2FPEF effectively capture typical HFpEF presentations. Additionally, low scores can help rule out the disease in many patients. However, the study highlights significant limitations when dealing with specific phenotypes. Atrial fibrillation alters natriuretic peptide levels and echocardiographic parameters, which can affect the accuracy of these diagnostic scores.
Obesity also impairs the ability of natriuretic peptide-based diagnostics to work correctly. Because these conditions change the biological markers the tests rely on, the scores may not be reliable for all patients. Readers should understand that these tools must be interpreted carefully within the context of individual patient phenotypes. While these scores are useful for typical cases, they are not perfect for everyone.
The main reason to be careful is that relying on these scores without considering specific conditions like obesity or atrial fibrillation could lead to misdiagnosis. This review does not provide medical advice but emphasizes the need for clinicians to interpret these scores alongside individual patient factors. Future research may further refine these tools for broader use.