ArticleOpen heart2025
Echocardiography reporting in heart failure with preserved ejection fraction: Delphi consensus study.
Article in Open heart, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
backgroundHeart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome in which signs and symptoms of heart failure (HF) occur despite a normal left ventricular ejection fraction. Transthoracic echocardiography (TTE) is the first-line imaging modality but disparities in patient pathways across the UK can lead to delayed diagnosis and treatment. We aimed to develop and validate a consistent, clinically appropriate and practical approach for reporting the echocardiographic suspicion of HFpEF.
methodsUsing the Delphi method, a steering group of nine UK experts identified key domains for discussion and generated consensus statements relevant to the echocardiographic detection of HFpEF. Using a four-point
resultsA total of 34 consensus statements were generated in seven domains: (1) challenges in the system approach to HFpEF; (2) enhancing referral for specialist review including echocardiography; (3) confidence in using a summary statement in an echo report; (4) identifying HFpEF and its underlying aetiology; (5) HF awareness, training and education; (6) refining multidisciplinary team roles in decision-making; (7) optimising patient experience.135 UK specialists experienced in managing HF participated in the survey, including physiologists/clinical scientists (n=43), HF specialist nurses (n=35), cardiologists (n=34), general practitioners (n=12), pharmacists (n=4) and others (n=7). 20 of 34 (59%) statements achieved very strong agreement, 10 of 34 (29%) achieved strong agreement and 4 of 34 (12%) did not meet the consensus threshold.
conclusionsDiagnosis of HFpEF requires access to essential diagnostic tools. Establishing standardised pathways for specialist assessment and referral, including TTE reporting of HFpEF, may help eliminate diagnostic delays and geographical disparities. Further education and awareness are crucial for improving detection rates, prompt referral and patient experience.
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