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H₂FPEF score

Estimates HFpEF probability in patients with unexplained dyspnea and preserved ejection fraction using clinical data and resting echocardiography.

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Check the population, units and version. The result shows the formula or classification; it does not make an automatic treatment decision.

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Method · Limits of application

H2FPEF/Reddy 2018: 6 factors, 0–9; 2 for BMI/3 for AF

H2FPEF was developed in people with unexplained dyspnea referred for invasive exercise hemodynamic assessment, comparing HFpEF with noncardiac causes. The score helps decide on further investigation; it does not alone confirm HFpEF and must not be automatically extrapolated to every cause of dyspnea. Population, ejection fraction and echocardiographic definitions must match the method.

Conditions of use

Check the population, units, inclusion and exclusion criteria, and version in the original source. A result alone does not establish a diagnosis, discharge decision or prescription.

Documented parameters

Heavy: BMI > 30 kg/m² (2)
Hypertensive: 2 or more antihypertensives (1)
Fibrillation: paroxysmal or persistent atrial fibrillation (3)
Pulmonary: pulmonary artery systolic pressure > 35 mmHg on echocardiography (1)
Elder: age > 60 years (1)
Filling: E/e' > 9 on echocardiography (1)

4/4 reference cases checked. Numerical tests are not clinical validation.

Sources and documentation

Documented formula

Transcribed from the source or a recorded revision; this is not a clinical recommendation.

Obesity (BMI > 30) = 2 · ≥ 2 antihypertensives = 1 · atrial fibrillation = 3 · PASP > 35 mmHg = 1 · age > 60 = 1 · E/e' > 9 = 1. Total 0 to 9.

References

Identifier: h2fpef

Original clinical content: Brazilian Portuguese.

Method version

H2FPEF/Reddy 2018: 6 factors, 0–9; 2 for BMI/3 for AF

h2fpef@native-2026-10-03+4a9c785e22a8

Source for the active edition

The bibliographic edition identifies the source. By itself, it proves neither full conformity of the formula nor clinical approval.

Synthetic cases checked (4)

Synthetic cases for checking the implementation, with no patient data.

Case 1

reference-001

Inputs

Heavy: BMI > 30 kg/m² (2): No
Hypertensive: 2 or more antihypertensives (1): No
Fibrillation: paroxysmal or persistent atrial fibrillation (3): No
Pulmonary: pulmonary artery systolic pressure > 35 mmHg on echocardiography (1): No
Elder: age > 60 years (1): No
Filling: E/e' > 9 on echocardiography (1): No

{
  "obesidade": false,
  "anti": false,
  "fa": false,
  "hp": false,
  "idade": false,
  "ee": false
}

Expected result

{
  "score": 0,
  "level": "low"
}

Actual result

{
  "score": 0
}

Case 2

reference-002

Inputs

Elder: age > 60 years (1): Yes
Filling: E/e' > 9 on echocardiography (1): Yes
Heavy: BMI > 30 kg/m² (2): No
Hypertensive: 2 or more antihypertensives (1): No
Fibrillation: paroxysmal or persistent atrial fibrillation (3): No
Pulmonary: pulmonary artery systolic pressure > 35 mmHg on echocardiography (1): No

{
  "idade": true,
  "ee": true,
  "obesidade": false,
  "anti": false,
  "fa": false,
  "hp": false
}

Expected result

{
  "score": 2,
  "level": "mid"
}

Actual result

{
  "score": 2
}

Case 3

reference-003

Inputs

Heavy: BMI > 30 kg/m² (2): Yes
Hypertensive: 2 or more antihypertensives (1): Yes
Elder: age > 60 years (1): Yes
Filling: E/e' > 9 on echocardiography (1): Yes
Fibrillation: paroxysmal or persistent atrial fibrillation (3): No
Pulmonary: pulmonary artery systolic pressure > 35 mmHg on echocardiography (1): No

{
  "obesidade": true,
  "anti": true,
  "idade": true,
  "ee": true,
  "fa": false,
  "hp": false
}

Expected result

{
  "score": 5,
  "level": "mid"
}

Actual result

{
  "score": 5
}

Case 4

reference-004

Inputs

Heavy: BMI > 30 kg/m² (2): Yes
Fibrillation: paroxysmal or persistent atrial fibrillation (3): Yes
Elder: age > 60 years (1): Yes
Hypertensive: 2 or more antihypertensives (1): No
Pulmonary: pulmonary artery systolic pressure > 35 mmHg on echocardiography (1): No
Filling: E/e' > 9 on echocardiography (1): No

{
  "obesidade": true,
  "fa": true,
  "idade": true,
  "anti": false,
  "hp": false,
  "ee": false
}

Expected result

{
  "score": 6,
  "level": "high"
}

Actual result

{
  "score": 6
}

Code and reproducibility

This tool’s code on GitHub

Download code and tests

Sources, version and reproduction instructions

The code tests are technical checks. Clinical approval and professional translation review are recorded separately.

Relationship with cancer research

General context — relationship to be defined

A resource for general clinical contexts. This edition does not assign a specific oncological relationship; selecting it for a study requires a justified question, population and purpose.