ArticleEuropean heart journal2019
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).
Article in European heart journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 5 registered trials, which are not on this map. Cited by 839 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Safety and Efficacy of Empagliflozin in Patients With End-stage Renal Disease and Heart Failure With Preserved Ejection Fraction - a Randomized Controlled Trial
Heart Failure and Preserved Ejection Fraction: Observation of Its Progression and Prognosis (HOPP-BERN)
Prospective Analysis of Diastolic Stress Tests to Detect Exercise Induced Heart Failure With Preserved Ejection Fraction (HFpEF) in Patients With Intermediate Risk (DEST-HF Study, Diastolic Exercise Stress Testing in Heart Failure)
Data-Driven Phenotyping in Heart Failure With Preserved Ejection Fraction
Impact of Combined cARdio-pUlmonary aSsessment on COPD Clinical Management: the ICARUS Study
Who cites it
839 citing papers in PubMed, 3 syntheses or guidelines pooled it, 1,712 citations in OpenAlex.
- Clinical Advances in Heart Failure with Preserved Ejection Fraction: A Systematic Review of Therapeutic and Mechanistic Evidence.Vascular health and risk management · 2026Pooled it
- Interplay between frailty and cardiometabolic disorders: from pathophysiology to clinical implications.Cardiovascular diabetology · 2025Pooled it
- Left atrial volume quantification by transthoracic echocardiography versus cardiovascular magnetic resonance: a systematic review and meta-analysis.The international journal of cardiovascular imaging · 2025Pooled it
- Left Atrial Volume Index and Left Ventricular Mass Index Determine the Benefits of Spironolactone in Patients With Heart Failure With Preserved Ejection Fraction.Journal of the American Heart Association · 2026Trial
- Heart failure therapy in patients with advanced cancer receiving specialized palliative care (EMPATICC trial).European heart journal · 2026Trial
- IMPROVE-DiCE, a 2-Part, Open-Label, Phase 2a Trial Evaluating the Safety and Effectiveness of Ninerafaxstat in Patients With Cardiometabolic Syndromes.Circulation · 2026Trial
- Safety and Short-Term Effects of Empagliflozin in Patients with Heart Failure and End-Stage Renal Disease.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2026Trial
- Assessing cardiovascular benefits of intensive blood pressure lowering in high-risk undiagnosed HFpEF patients.ESC heart failure · 2025Trial
- Effects of Dapagliflozin on Left Atrial Ejection Force in Heart Failure with Preserved Ejection Fraction: DAPA-Left Atrial Ejection Force Trial.Anatolian journal of cardiology · 2025Trial
- HEART Camp Connect-Promoting adherence to exercise in adults with heart failure with preserved ejection fraction.ESC heart failure · 2025Trial
- Exercise, Nutrition and GLP-1 Medicines to Improve Body Weight and Muscle Function in Heart Failure with Preserved Ejection Fraction.Current heart failure reports · 2026Review
- Automated assessment of echocardiograms to aid diagnosis of heart failure with preserved ejection fraction.European heart journal. Digital health · 2026Article
- Artificial intelligence-enabled electrocardiography for detection of left ventricular diastolic dysfunction: a systematic review and meta-analysis.European heart journal. Digital health · 2026Review
- Prognostic significance of left atrial reservoir strain during exercise in patients with heart failure.International journal of cardiology. Heart & vasculature · 2026Article
- From snapshot to trajectory: A multimodality right-heart monitoring framework across the heart failure spectrum.American heart journal plus : cardiology research and practice · 2026Review
- Mitral annular calcification severity and invasive hemodynamic confirmation of HFpEF: A prospective observational study.Medicine · 2026Observational
- The LEDA Score: An Integrated Echocardiographic Score for the Diagnosis of HFpEF.JACC. Advances · 2026Article
- Within a Heartbeat: A Machine Learning Approach Using VCG for Heart Failure Assessment in Sinus Rhythm.Journal of personalized medicine · 2026Article
- Body Mass Index and LDL Cholesterol Across Controls, Hypertension, and Ischemic Heart Disease with Preserved Ejection Fraction: A Single-Center Retrospective Cross-Sectional Study.Journal of clinical medicine · 2026Article
- Development of a heart failure with preserved ejection fraction risk prediction score in primary care settings with a high HIV prevalence.Open heart · 2026Observational
779 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
24 authors at 19 institutions in 15 countries.
Funding
No grant is acknowledged in the PubMed record.
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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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.