title: Prognostic significance of applying the European Society of Cardiology consensus algorithm for heart failure with preserved systolic function diagnosis.
abstract: BACKGROUND
  The diagnosis of heart failure with preserved left ventricular ejection fraction (HFpEF) is challenging. Although diagnostic criteria have been proposed, limited information exists concerning its implication on prognosis. We aimed to evaluate the prognostic significance of applying the European Society of Cardiology algorithm for HFpEF diagnosis, namely the tissue Doppler imaging information, in patients with acute heart failure (HF).
  
  
  OBJECTIVE
  The application of the European Society of Cardiology algorithm for HFpEF diagnosis, identifies a group of HF patients with high morbidity and mortality.
  
  
  METHODS
  Consecutive patients admitted due to acute HF were recruited. The European Society of Cardiology algorithm was used in the HFpEF diagnosis. Patients were followed for a 6-month period and mortality and rehospitalization due to HF were recorded.
  
  
  RESULTS
  A total of 491 patients were included in this registry. Mean patient age was 78 years and 63% were women; 177 patients had HFpEF and 314 had HF with reduced ejection fraction (HFrEF). Of the HFpEF patients, 44.8% had an E/E' ratio >15 and 1.8% had an E/E' ratio <8. Patients with HFpEF and those with HFrEF had a similarly dismal prognosis when considering all-cause mortality, and morbidity and mortality, but there was a trend for better survival when HF death was the outcome in analysis (hazard ratio 1.63 [95% confidence interval: 0.95-2.80, P = 0.08]).
  
  
  CONCLUSIONS
  The use of objective criteria for diagnosis of HFpEF identifies patients with similar outcomes as patients with HFrEF; this observation increases the robustness of the diagnostic criteria for HFpEF. The use of objective criteria for the diagnosis of HFpEF identifies patients with a similarly ominous prognosis as patients with HFrEF; this observation increases the robustness of the diagnostic criteria for HFpEF. Identifying these patients based on objective criteria, as we did, is an important step for future investigation, namely drugs, warranted to the HFpEF approach.
authors.affiliation: Department of Cardiology, Centro Hospitalar São João, University of Porto, Porto, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Almeida
authors.forename: João
authors.initials: J
authors.lastname: Rodrigues
authors.forename: Patricia
authors.initials: P
authors.lastname: Lourenço
authors.forename: Maria Julia
authors.initials: MJ
authors.lastname: Maciel
authors.forename: Paulo
authors.initials: P
authors.lastname: Bettencourt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002309:Cardiology; D005060:Europe; D005260:Female; D006333:Heart Failure / Q000175:diagnosis*; D006801:Humans; D008297:Male; D011379:Prognosis; D012955:Societies, Medical; D013318:Stroke Volume; D013599:Systole