Association between diastolic stress test and H2FPEF score

Jairo A. Rendón-Giraldo, Department of Cardiology, CES University; Fellow of the American College of Cardiology (FACC) and the European Society of Cardiology (FESC); Universidad de Antioquia, Medellín, Colombia
Camila Lema, Department of Cardiology, CES University, Universidad de Antioquia, Medellín, Colombia
Clara Saldarriaga-Giraldo, Department of Cardiology and Heart Failure, Universidad Pontificia Bolivariana, Clínica cardioVID; Universidad de Antioquia, Medellín; Medellín, Colombia

Objective: Heart failure with preserved ejection fraction is a highly prevalent disease; some advances for improving the diagnosis are the development of the H2FPEF score and the diastolic stress test for the evaluation of diastolic function. The objective is to describe the clinical and echocardiographic characteristics of patients referred for stress tests, and the association between the H2FPEF score and the results of the diastolic test. Methods: This is an analytical, observational, retrospective study. An exercise stress test was performed. The Chi-square test was used to establish an association between H2FpEF score and diastolic stress test results. Patients over the age of 18, in sinus rhythm, with the left ventricular ejection fraction > 54%, with no more than mild diastolic dysfunction on the baseline echocardiogram were included in the study. Results: A total of 99 patients met the eligibility criteria. About 49.5% were women, median age was 62.2 years. The H2FPEF score was low in 27.2%, intermediate 71.7%, and 1% in the high range. There was a high prevalence of hypertension 58.6%, diabetes 12.1%, and coronary disease 20.2%. The stress test was positive for diastolic dysfunction in 36.4% of the patients. A statistically significant association was found between the H2FPEF score and the diastolic stress test (p = 0.02). Conclusions: Although clinical scores such as H2FPEF help identify patients, a high percentage of patients are classified in the intermediate range. The diastolic stress test can help to make the diagnosis of diastolic function in this group of patients.

Keywords: Heart failure. Stress test. Diastolic function. Echocardiogram.