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Cited by 1,855

The DOI matches its Crossref record; 17 of the 17 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 access
Pieske, Burkert, Tschöpe, Carsten, de Boer, Rudolf A, Fraser, Alan G, Anker, Stefan D, Donal, Erwan, Edelmann, Frank, Fu, Michael, Guazzi, Marco, Lam, Carolyn S P, Lancellotti, Patrizio, Melenovsky, Vojtech, Morris, Daniel A, Nagel, Eike, Pieske-Kraigher, Elisabeth, Ponikowski, Piotr, Solomon, Scott D, Vasan, Ramachandran S, Rutten, Frans H, Voors, Adriaan A, Ruschitzka, Frank, Paulus, Walter J, Seferovic, Petar, Filippatos, Gerasimos·2019·European Heart Journal
DOI 10.1093/eurheartj/ehz641
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Abstract

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 HF 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 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′), left ventricular (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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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 Heart Journal
Publisher
Oxford University Press (OUP)
Published
2019-08-31
Volume
40
Issue
40
Pages
3297-3317
ISSN
  • 0195-668X (ISSN-L)
  • 1522-9645
DOI
10.1093/eurheartj/ehz641
OpenAlex
W2971111962
Cited by
1,855
References
17
FWCI
118.02
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/10.1093/eurheartj/ehz641
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. (2019). 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 Heart Journal. https://doi.org/10.1093/eurheartj/ehz641

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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.