Abstract

Purposes: To evaluate the association between the H2FPEF score and NYHA class, NT-ProBNP levels, and cardiovascular events in patients with heart failure with preserved ejection fraction.

Methods: A cross-sectional study with follow-up was conducted on 171 patients diagnosed with heart failure with preserved left ventricular ejection fraction at the Cardiology Department – Cardiology Center from May 1st, 2023 to April 30th, 2024.

Results: There was a statistically significant difference in NYHA symptoms across H2FPEF groups, with NYHA class 3-4 symptoms being highest in the group with H2FPEF ≥ 6, followed by the H2FPEF 3-5 group, and lowest in the group with ≤ 2 points (41.2%, 22.7%, and 10.0% respectively). NT-proBNP levels differed among the H2FPEF groups, with median values increasing as the H2FPEF score increased (316.10 pg/ml in the 2-point group, 596.10 pg/ml in the 3-5 point group, and 1936.00 pg/ml in the ≥ 6 point group) (p < 0.05). There were also significant differences in cholesterol and triglyceride levels between H2FPEF groups (p < 0.05). Kaplan-Meier time-to-event analysis showed that the probability of cardiovascular events and heart failure hospitalization increased with higher H2FPEF scores (log-rank test, p = 0.006 and p = 0.003, respectively). The H2FPEF score is valuable in predicting cardiovascular events in heart failure patients with preserved ejection fraction, although the predictive value is low (p < 0.05). The optimal cut-off score is 3.5 points for maximum sensitivity of 53.5% and specificity of 72.7% in predicting cardiovascular events.

Conclusion: There is an association between the H2FPEF score and NYHA class, NT-ProBNP levels, and cardiovascular events in patients with heart failure with preserved ejection fraction.