[Usefulness of the H2FPEF score in the diagnosis and prognosis of heart failure with preserved ejection fraction in primary care].

OBJECTIVE: To determine, in a group of patients with a diagnosis of heart failure (HF) in primary care, the probability of presenting heart failure with preserved ejection fraction (HFpEF) according to the H2FPEF score and its association with one-year morbidity and mortality. DESIGN: Cross-sectional descriptive study. SETTING: Seven primary care centres in Barcelona. PARTICIPANTS: Patients with HF (ICD-10: I.50) and left ventricular ejection fraction ≥50%. INTERVENTIONS: analysis of electronic health record data from primary care and clinical interview with patients. MAIN MEASUREMENTS: Clinical, laboratory and echocardiographic variables were collected. The H2FPEF score was calculated and patients were classified accordingly. The association between the score and the composite outcome (all-cause mortality or HF hospitalisation) at one year was analysed. RESULTS: A total of 628 patients were included, of whom 169 had complete data for score calculation. Of these, 47.9% had a high probability of HFpEF. These patients were older, with more comorbidities and worse functional class. The incidence of the composite event was higher in the high-probability group (64.4%) compared to the low/intermediate group (35.6%; P=.011). In multivariate analysis, high probability showed a trend towards association with the composite outcome (OR: 2.06; 95% CI: 0.96-4.54; P=.066). CONCLUSIONS: The H2FPEF score is a useful and feasible tool in primary care for improving the diagnosis and risk stratification of morbidity and mortality in patients with suspected HF.