Diagnostic significance of H2FPEF and HFA-PEFF scores with oncostatin M levels in heart failure with preserved ejection fraction.

BACKGROUND

Heart failure with preserved ejection fraction (HFpEF) represents approximately half of all heart failure cases, and its prevalence is rising with an aging population and increasing comorbidities. Diagnosis is challenging due to heterogeneous clinical features and nonspecific symptoms. To improve diagnostic accuracy, scores such as the HFA-PEFF (Heart Failure Association Pre-test Assessment, Echocardiography & Natriuretic Peptide, Functional Testing, Final Etiology) and H2FPEF have been proposed. Oncostatin M (OSM), a cytokine of the interleukin‑6 family, is involved in cardiac inflammation, fibrosis, and remodeling, but its diagnostic role in HFpEF remains unclear.

METHODS

This single-center, cross-sectional study enrolled 71 patients with suspected HF symptoms (dyspnea, fatigue, edema) and a left ventricular ejection fraction ≥ 50%. Demographic, laboratory, and echocardiographic data were recorded. HFpEF likelihood was assessed using the HFA-PEFF and H2FPEF scores. Serum OSM levels were measured, and patients were classified into low-intermediate- and high-risk groups.

RESULTS

Mean patient age was 67.0 years (63.4% female). In the high-risk H2FPEF group, only hypertension showed a significant association (p = 0.032). By contrast, the high-risk HFA-PEFF group showed higher left atrial volume index, left ventricular mass index, and E/e' ratio; NT-proBNP and OSM levels were also significantly increased (51.3 vs. 14.4 pg/mL; p < 0.001). Receiver operating characteristic analysis showed that OSM had strong discriminatory power for the HFA-PEFF but not the H2FPEF score.

CONCLUSION

Serum OSM levels correlated more strongly with the HFA-PEFF score, which incorporates structural and functional cardiac parameters. Thus, OSM may serve as a complementary biomarker to improve HFpEF diagnosis when used with the HFA-PEFF scoring system.