Underlying heart failure with preserved ejection fraction (HFpEF) has been identified in many transcatheter aortic valve implantation (TAVI) candidates in addition to symptomatic aortic stenosis. In view of the challenges experienced in diagnosing HFpEF, researchers herein assessed the HFA-PEFF score, which was proposed by the Heart Failure Association of the European Society of Cardiology as part of a novel diagnostic algorithm, for its prognostic value in patients with preserved ejection fraction after TAVI.

• In this single-center study, a total of 570 consecutive TAVI patients with a preserved left ventricular ejection fraction of ≥ 50% were included.

• Patients with an HFA-PEFF score of ≥ 5 [n = 239 (41.9%)] vs < 5 points [n = 331 (58.1%)] were compared.

• Researchers noted higher rates of comorbidities commonly linked with HFpEF, a higher rate of new pacemaker implantation after TAVI, increased risk of the primary composite endpoint (a composite of all-cause mortality or first heart failure rehospitalization within 1 year after TAVI) (25.5% vs 10.0%), and rehospitalization for heart failure (11.7% vs 3.9%) among patients with an HFA-PEFF score ≥ 5.

• In multivariable analysis, an HFA-PEFF score ≥ 5 is identified as an independent risk factor for the composite endpoint and for all-cause mortality.

• The HFA-PEFF score is suggested as a practical tool that can easily be incorporated into risk stratification algorithms for TAVI patients.