The DOI matches its Crossref record; 263 of the 263 references it cites were found in a registry or an index.
How to Diagnose Heart Failure with Preserved Ejection Fraction: The HFA–PEFF Diagnostic Algorithm: A Consensus Recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)
Open accessAbstract
Making a firm diagnosis of chronic heart failure with preserved ejection fraction (HFpEF) remains a challenge. We recommend a new stepwise diagnostic process, the ‘HFA–PEFF diagnostic algorithm’. Step 1 (P=Pre-test assessment) is typically performed in the ambulatory setting and includes assessment for heart failure symptoms and signs, typical clinical demographics (obesity, hypertension, diabetes mellitus, elderly, atrial fibrillation), and diagnostic laboratory tests, electrocardiogram, and echocardiography. In the absence of overt non-cardiac causes of breathlessness, HFpEF can be suspected if there is a normal left ventricular (LV) ejection fraction, no significant heart valve disease or cardiac ischaemia, and at least one typical risk factor. Elevated natriuretic peptides support, but normal levels do not exclude a diagnosis of HFpEF. The second step (E: Echocardiography and Natriuretic Peptide Score) requires comprehensive echocardiography and is typically performed by a cardiologist. Measures include mitral annular early diastolic velocity (e′), LV filling pressure estimated using E/e′, left atrial volume index, LV mass index, LV relative wall thickness, tricuspid regurgitation velocity, LV global longitudinal systolic strain, and serum natriuretic peptide levels. Major (2 points) and Minor (1 point) criteria were defined from these measures. A score ≥5 points implies definite HFpEF; ≤1 point makes HFpEF unlikely. An intermediate score (2–4 points) implies diagnostic uncertainty, in which case Step 3 (F1: Functional testing) is recommended with echocardiographic or invasive haemodynamic exercise stress tests. Step 4 (F2: Final aetiology) is recommended to establish a possible specific cause of HFpEF or alternative explanations. Further research is needed for a better classification of HFpEF.
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Self-citationRudski, L. G., Lai, W. W., Afilalo, J., Hua, L., Handschumacher, M. D., Chandrasekaran, K., Solomon, S. D., Louie, E. K., & Schiller, N. B. (2010) · Journal of the American Society of Echocardiography · doi:10.1016/j.echo.2010.05.010 · Cited by 7,049
Self-citation2017 ESC/EACTS Guidelines for the management of valvular heart disease
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Self-citation2016 ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure
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Self-citation2013 ESC guidelines on the management of stable coronary artery disease
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Self-citationAge-predicted maximal heart rate revisited
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Recommendations for chamber quantification☆
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A Novel Paradigm for Heart Failure With Preserved Ejection Fraction
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Self-citationThe natural history of congestive heart failure: the Framingham study
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Cited by
Kittleson, M. M., Panjrath, G. S., Amancherla, K., Davis, L. L., Deswal, A., Dixon, D. L., Januzzi, J. L., & Yancy, C. W. (2023) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2023.03.393 · Cited by 554
Lopez-Jimenez, F., Almahmeed, W., Bays, H., Cuevas, A., Di Angelantonio, E., le Roux, C. W., Sattar, N., Sun, M. C., Wittert, G., Pinto, F. J., et al. (2022) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwac187 · Cited by 362
Myocardial Gene Expression Signatures in Human Heart Failure With Preserved Ejection Fraction
Hahn, V. S., Knutsdottir, H., Luo, X., Bedi, K., Margulies, K. B., Haldar, S. M., Stolina, M., Yin, J., Khakoo, A. Y., Vaishnav, J., et al. (2021) · Circulation · doi:10.1161/circulationaha.120.050498 · Cited by 291
Heart failure with preserved ejection fraction: everything the clinician needs to know
Campbell, P., Rutten, F. H., Lee, M. M., Hawkins, N. M., & Petrie, M. C. (2024) · The Lancet · doi:10.1016/s0140-6736(23)02756-3 · Cited by 269
Self-citationObesity, venous capacitance, and venous compliance in heart failure with preserved ejection fraction
Sorimachi, H., Burkhoff, D., Verbrugge, F. H., Omote, K., Obokata, M., Reddy, Y. N. V., Takahashi, N., Sunagawa, K., & Borlaug, B. A. (2021) · European Journal of Heart Failure · doi:10.1002/ejhf.2254 · Cited by 124
Metadata
- Authors
- Pieske, B., Tschöpe, C., de Boer, R. A., Fraser, A. G., Anker, S. D., Donal, E., Edelmann, F., Fu, M., Guazzi, M., Lam, C. S. P., Lancellotti, P., Melenovsky, V., Morris, D. A., Nagel, E., Pieske-Kraigher, E., Ponikowski, P., Solomon, S. D., Vasan, R. S., Rutten, F. H., Voors, A. A., Ruschitzka, F., Paulus, W. J., Seferovic, P., & Filippatos, G.
- Venue
- European Journal of Heart Failure
- Publisher
- Oxford University Press (OUP)
- Published
- 2020-03-01
- Volume
- 22
- Issue
- 3
- Pages
- 391-412
- ISSN
- 1388-9842 (ISSN-L)
- 1879-0844
- OpenAlex
- W4242608813
- Cited by
- 394
- References
- 263
- FWCI
- 31.42
- Type
- journal article
- Language
- en
- Open access
- bronze
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- CoChat. (2026). Citation check: How to Diagnose Heart Failure with Preserved Ejection Fraction: The HFA–PEFF Diagnostic Algorithm: A Consensus Recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). https://app.cochat.ai/papers/10.1002/ejhf.1741
- The paper
- Pieske, B., Tschöpe, C., de Boer, R. A., Fraser, A. G., Anker, S. D., Donal, E., Edelmann, F., Fu, M., Guazzi, M., Lam, C. S. P., Lancellotti, P., Melenovsky, V., Morris, D. A., Nagel, E., Pieske-Kraigher, E., Ponikowski, P., Solomon, S. D., Vasan, R. S., Rutten, F. H., . . . Filippatos, G. (2020). How to Diagnose Heart Failure with Preserved Ejection Fraction: The HFA–PEFF Diagnostic Algorithm: A Consensus Recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC). European Journal of Heart Failure. https://doi.org/10.1002/ejhf.1741
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