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논문분류	춘계학술대회 초록집
제목	Diagnosis of heart failure with preserved ejection fraction in hemodialysis patients by heart failure scoring system, a retrospective-cohort study
저자	JIHOON PARK
출판정보	2024; 2024(1):
키워드
초록	Objectives: Diagnosis of heart failure is based on symptoms and signs of cardiac dysfunction plus left ventricular ejection fraction(LVEF). However, symptoms and signs of heart failure can be confusing in most patients with renal disease, making HFpEF difficult to differentiate from volume overload in patients with ESRD. From 2018, the ESC guideline of heart failure(HFA-ESC) introduced diagnostic algorithm for HFpEF, and Mayo clinic introduced different scoring system(H2F-PEF). We compared these two scoring systems in the patients with ESRD on hemodialysis sessions. Methods: Patients were enrolled from our prospective cohort, with inclusion criteria of age older than 18 years and treatment with HD or HDF for at least 3 months. A total of 863 patients were recruited, and 572 patients are included. 46 patients had LVEF below 50%, so we tried to examine 526 patients. By using the HFA-ESC guideline, we sorted patients into the HFpEF group that met 2 major criteria because the BNP data were absent. For the H2FPEF score, we sorted patients with intermediate scores (2~5) in the HFpEF group. We compared these two scoring systems and surveyed risk factors and overall survival rates for each scored patient. Results: 407 people were diagnosed with HFpEF, and 119 people were in the low-risk group by the HFA-ESC algorithm. Additionally, 421 people were diagnosed with intermediate likelihood of HFpEF, and 105 people were in the low-risk group by H2FPEF scoring. Patients in the HFpEF group of the H2FPEF scoring system tended to have more severe anemia, lower serum iron, and lower albumin levels despite their higher BMI. We found that the H2F-PEF scoring system could predict the mortality of patients more accurately, even after age-matched Cox regression. Conclusions: In patients with end-stage renal disease, the H2F-PEF scoring system was a better diagnostic tool for the diagnosis of HFpEF and predicting patient outcomes.
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