Diagnostic Criteria for HF

HF was diagnosed based on the symptoms and/or signs of HF, echocardiography report, and the Heart Failure Association (HFA)-PEFF (P, pre-test assessment; E, echocardiography and natriuretic peptide score; F1, functional testing; F2, final etiology) diagnostic algorithm (23). The algorithm consists of three domains: functional, morphological, and biomarker domains. For each domain, 2 points are scored when the main criteria are met, while 1 point is scored when minor criteria are met. Points from different domains are then summed. A total score of ≥5 is considered a diagnosis of HF preserved ejection fraction (HFpEF); while a score of ≤1 indicates an unlikely diagnosis of HFpEF (24). The diagnosis of HF with mildly reduced ejection fraction (HFmrEF) requires the presence of symptoms and/or signs of HF, the LVEF between 40 and 50%, elevated levels of natriuretic peptides (BNP ≥35 pg/mL or NT-proBNP ≥125 pg/mL), and other evidence of structural heart disease (25). The diagnosis of HF with reduced ejection fraction (HFrEF) requires the presence of symptoms and/or signs of HF and a reduced ejection fraction (LVEF ≤40%) (25).