{
  "abstract": "Background Identifying heart failure with preserved ejection fraction (HFpEF) remains challenging. Scoring systems suggested by European Heart Failure Association (HFA-PEFF score) and Reddy et al. 2018 (H2FPEF score), are commonly used in clinical practice. Practically speaking, the majority of the patients remain unidentified as they fall into an intermediate/require further evaluation scoring category, creating a diagnostic ‘gray zone.’ As a non-invasive and potentially more cost-effective investigation, cardiopulmonary exercise testing (CPET) could help solve this problem. The study aimed at understanding the role of CPET in the identification of patients with HFpEF.Methods As a part of a bigger project, a pilot study cross-sectional study was conducted at the Cardiac Investigative Unit, Ulster Hospital, Belfast. The study involved 13 patients recruited via the hospital system with clinical suspicion of HFpEF based on symptoms and echocardiographic findings (LVEF>50%). We assessed the HFpEF probability using the HFA-PEFF and the H2FPEF score. All patients went through cardiopulmonary exercise testing till exhaustion yielding a valid test. We hypothesized that CPET parameters (VO2peak, VE/VCO2 slope, and OUES) might provide complementary information to aid the identification of HFpEF on top of probability HFA-PEFF and H2PEFF scores.Results A total of 13 HFpEF patients with age 61.7 ± 5.6 years were included. Based on the HFA-PEFF and H2PEFF scoring system, out of the 13 patients, 8 (61.5%) were found to be in the ‘needs further evaluation’ category, while 3 (23.1%) were based highly unlikely HFpEF and 2 (15.4%) highly likely HFpEF categories. CPET results of 8 unidentified patients showed, VO2peak, VE/VCO2, and OUES to be VO2peak and VE/CO2 and OUES were recorded to be 13.8 ± 1.4 and 39.4 ± 9.8 and 1503 ± 1235 respectively. These patients fell into the categories of Webers Class III and Ventilatory Class III showing low cardiorespiratory and ventilatory efficiency corresponding highly with HFpEF.Conclusion CPET can be a vital investigatory tool that would augment the current scoring system and help in identifying HFpEF patients early in their disease timeline and may be used to initiate appropriate early targeted management.",
  "authors": [
    {
      "affiliations": [
        "Ulster University and Ulster Hospital, Belfast, UK"
      ],
      "name": "Saqib Javaid"
    },
    {
      "affiliations": [
        "Ulster University, Belfast, UK"
      ],
      "name": "Chris Bleakley"
    },
    {
      "affiliations": [
        "Ulster University, Belfast, UK"
      ],
      "name": "George Kernohan"
    },
    {
      "affiliations": [
        "Ulster University, Belfast, UK"
      ],
      "name": "Rachel Savage"
    },
    {
      "affiliations": [
        "Ulster Hospital, Belfast, UK"
      ],
      "name": "Peter McKavanagh"
    },
    {
      "affiliations": [
        "Ulster Hospital, Belfast, UK"
      ],
      "name": "Elena Connell"
    }
  ],
  "title": "P40 Cardiopulmonary exercise testing in heart failure with preserved ejection fraction: a game-changer for patients",
  "uid": "92d60f1b-1c67-54be-82ca-4482bd93d2c3"
}