Content area
Sodium-glucose cotransporter-2 (SGLT-2) inhibitors have been shown to reduce the composite of cardiovascular mortality and hospitalization for heart failure in those with HFpEF.2 Other studies have shown that glucagon-like peptide-1 receptor agonists may help decrease heart failure exacerbations and improve quality of life, as measured by the Kansas City Cardiomyopathy Questionnaire.3 AHA/ACC/HFSA guidelines recommend blood pressure and atrial fibrillation control and use of SGLT-2 inhibitors for individuals with HFpEF. The score was validated with a cohort of 100 additional patients and had an area under the curve (AUC) of 0.886 (values of more than 0.8 are generally considered good).4 The European Society of Cardiology released an alternative diagnostic pathway for HFpEF called the Heart Failure Association-Pretest assessment, Echocardiography and natriuretic peptide, Functional testing, Final aetiology (HFA-PEFF) score, which assigns points for different functional and structural findings on echocardiography and varying levels of elevated brain natriuretic peptide (BNP; different cutoffs for BNP are used based on whether a patient is in sinus rhythm or atrial fibrillation).5 This score was validated in two cohorts of 270 and 459 patients, with an AUC of 0.90.6 The H2FPEF and HFA-PEFF scores may require more information than is available during an ambulatory encounter for exertional dyspnea in a setting without immediate access to echocardiography or BNP testing. AARON SAGUIL, MD, MPH; PETRA TOWNSEND, MD; and MARK H. EBELL, MD, MS 1 Heidenreich, PA; Bozkurt, B; Aguilar, D et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.