H2FPEF Score

H2FPEF Score: Discriminates heart failure with preserved ejection fraction (HFpEF) from non-cardiac causes of dyspnea. Higher scores increase the likelihood of HFpEF.

Clinical & Echo Criteria

Age

>60y = +1 pt

E/e' Ratio

>9 = +1 pt

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

Evaluation of patients with undifferentiated dyspnea and suspected Heart Failure with Preserved Ejection Fraction (HFpEF).

To discriminate between HFpEF and non-cardiac causes of dyspnea.

As an alternative to or in conjunction with the HFA-PEFF algorithm.

How it Works

Scoring Variables

H2: Heavy (BMI > 30)	2 pts
H: Hypertension (meds ≥ 2)	1 pt
A: Atrial Fibrillation (Paroxysmal or Persistent)	3 pts
P: Pulmonary Hypertension (PASP > 35 mmHg)	1 pt
E: Elder (Age > 60)	1 pt
F: Filling Pressures (E/e' > 9)	1 pt

Probability of HFpEF

Score 0-1	< 15% (Rule out)
Score 2-5	15-80% (Intermediate)
Score 6-9	> 90% (Rule in)

Last Comprehensive Review: 2026-07-17

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

Evaluation of patients with undifferentiated dyspnea and suspected Heart Failure with Preserved Ejection Fraction (HFpEF).

To discriminate between HFpEF and non-cardiac causes of dyspnea.

As an alternative to or in conjunction with the HFA-PEFF algorithm.

How it Works

Scoring Variables

H2: Heavy (BMI > 30)	2 pts
H: Hypertension (meds ≥ 2)	1 pt
A: Atrial Fibrillation (Paroxysmal or Persistent)	3 pts
P: Pulmonary Hypertension (PASP > 35 mmHg)	1 pt
E: Elder (Age > 60)	1 pt
F: Filling Pressures (E/e' > 9)	1 pt

Probability of HFpEF

Score 0-1	< 15% (Rule out)
Score 2-5	15-80% (Intermediate)
Score 6-9	> 90% (Rule in)

Last Comprehensive Review: 2026-07-17

Recent Journal Updates

British J HaematologyJul 22, 2026

Eradication of PPMI clone and improvement in cytopenia using cryopreserved autologous haematopoietic stem cells

Clinical Context

We think this has broad domain relevance to H2FPEF Score.

JAMAJul 21, 2026

Correction to Primary Composite Outcome in a Trial of Transfusion Strategy

Clinical Context

We think this has broad domain relevance to H2FPEF Score.

WHO NewsJul 15, 2026

New WHO guidelines: up to 45% of dementia risk could be prevented or delayed

Clinical Context

We think this has broad domain relevance to H2FPEF Score.

H2FPEF Score

Clinical & Echo Criteria

When to Use

When to Use

How it Works

Scoring Variables

Probability of HFpEF

Clinical Pearls

H2FPEF vs. HFA-PEFF

Next Steps

Complementary Calculators

The Evidence

Primary Derivation

A Simple, Evidence-Based Approach to Help Guide Diagnosis of Heart Failure With Preserved Ejection Fraction.

When to Use

When to Use

How it Works

Scoring Variables

Probability of HFpEF

Clinical Pearls

H2FPEF vs. HFA-PEFF

Next Steps

Complementary Calculators

The Evidence

Primary Derivation

A Simple, Evidence-Based Approach to Help Guide Diagnosis of Heart Failure With Preserved Ejection Fraction.

Recent Journal Updates

H2FPEF Score

Clinical & Echo Criteria

When to Use

When to Use

How it Works

Scoring Variables

Probability of HFpEF

Clinical Pearls

H2FPEF vs. HFA-PEFF

Next Steps

Complementary Calculators

The Evidence

Primary Derivation

A Simple, Evidence-Based Approach to Help Guide Diagnosis of Heart Failure With Preserved Ejection Fraction.

When to Use

When to Use

How it Works

Scoring Variables

Probability of HFpEF

Clinical Pearls

H2FPEF vs. HFA-PEFF

Next Steps

Complementary Calculators

The Evidence

Primary Derivation

A Simple, Evidence-Based Approach to Help Guide Diagnosis of Heart Failure With Preserved Ejection Fraction.

Recent Journal Updates