Forsyth F, Brimicombe J, Cheriyan J, et al. - Patients with heart failure with preserved ejection fraction (HFpEF) are difficult to identify in primary care, and more knowledge of the condition, as well as clear diagnostic pathways and specialist support, are required. Diagnostic algorithms and scores can provide systematic approaches to diagnosis, however, they might be difficult to employ in elderly multi-morbid individuals. Where diagnostic doubt persists, pragmatic considerations must be made about the utility of additional testing vs care of presumptive HFpEF.

• In total, 152 patients (86% primary care, mean age 78.5, 40% female) were recruited; 93 (61%) had HFpEF confirmed.

• The majority of patients displayed clinical features of HFpEF, although those with verified HFpEF were more likely to be female, obese, functionally impaired, and symptomatic.

• Although some echocardiographic results were suggestive with HFpEF, there was no difference in natriuretic peptide levels.

• The H ₂ FPEF and HFA-PEFF scores did not differ substantially by group, while verified HFpEF cases were more likely to have scores indicating a high likelihood of HFpEF.