Heart & lung : the journal of critical care · 2026
Screening for heart failure with preserved ejection fraction using the BREATH2 score: diagnostic performance and prognostic value.
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Kinoshita Masaki, Tasaka Tatsuro, Fujimoto Kaori, Sato Sumiko, Saito Makoto, Fujisawa Yuki, Nishimura Kazuhisa, Inoue Katsuji, Ikeda Shuntaro, Sumimoto Takumi, Yamaguchi Osamu
Аннотация
BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is more prevalent in aging societies and remains challenging to diagnose in primary care. The BREATH2 score is a screening tool for diagnosing HFpEF in Japanese primary care settings. However, its broader utility and association with cardiac outcomes are unclear.
OBJECTIVES: This study aimed to evaluate the diagnostic utility of the BREATH2 score for HFpEF and its prognostic value for cardiac event.
METHODS: This retrospective, single-center study examined 234 patients (median age 73 years; 25.6% female) with a left ventricular ejection fraction ≥ 50%. HFpEF was diagnosed using the HFA-PEFF algorithm. The BREATH2 scores were categorized as low (≤ 3), intermediate (4-5), or high (≥ 6) risk. Defined cardiac event was either cardiac death or HF hospitalization.
RESULTS: HFpEF prevalence rose progressively with the BREATH2 score, with 10.5% of participants in the low-, 38.6% in the intermediate-, and 70.3% in the high-risk groups. The BREATH2 score discriminated HFpEF from non-HFpEF better than the H₂FPEF score (AUC 0.81 vs. 0.69, P < 0.001). During the median follow-up period of 287 days, 17 (7.3%) patients experienced first cardiac event. Each 1-point increase in the BREATH2 score was associated with increased risk of a cardiac event (Hazard ratio 1.94, P < 0.001), independent of H₂FPEF or HFA-PEFF scores. Kaplan-Meier analysis demonstrated increasing cardiac event as the BREATH2 score increased.
CONCLUSIONS: The BREATH2 score was associated with HFpEF and more cardiac event, suggesting possible utility as a screening tool in primary care.
OBJECTIVES: This study aimed to evaluate the diagnostic utility of the BREATH2 score for HFpEF and its prognostic value for cardiac event.
METHODS: This retrospective, single-center study examined 234 patients (median age 73 years; 25.6% female) with a left ventricular ejection fraction ≥ 50%. HFpEF was diagnosed using the HFA-PEFF algorithm. The BREATH2 scores were categorized as low (≤ 3), intermediate (4-5), or high (≥ 6) risk. Defined cardiac event was either cardiac death or HF hospitalization.
RESULTS: HFpEF prevalence rose progressively with the BREATH2 score, with 10.5% of participants in the low-, 38.6% in the intermediate-, and 70.3% in the high-risk groups. The BREATH2 score discriminated HFpEF from non-HFpEF better than the H₂FPEF score (AUC 0.81 vs. 0.69, P < 0.001). During the median follow-up period of 287 days, 17 (7.3%) patients experienced first cardiac event. Each 1-point increase in the BREATH2 score was associated with increased risk of a cardiac event (Hazard ratio 1.94, P < 0.001), independent of H₂FPEF or HFA-PEFF scores. Kaplan-Meier analysis demonstrated increasing cardiac event as the BREATH2 score increased.
CONCLUSIONS: The BREATH2 score was associated with HFpEF and more cardiac event, suggesting possible utility as a screening tool in primary care.