HFA-PEFF Score Calculator
Estimate HFA-PEFF points (0–6) using the three domains: Functional, Morphological, and Biomarkers.
What is the HFA-PEFF score?
The HFA-PEFF score is a structured method to estimate the likelihood of heart failure with preserved ejection fraction (HFpEF). It combines evidence from three domains:
- Functional: diastolic function and hemodynamic stress markers on echocardiography.
- Morphological: structural changes such as left atrial enlargement and left ventricular hypertrophy/remodeling.
- Biomarkers: natriuretic peptides (BNP or NT-proBNP), interpreted with rhythm-specific thresholds.
Each domain contributes up to 2 points, so total score ranges from 0 to 6.
How this calculator works
This page uses a practical clinical workflow:
- Select the level met for Functional and Morphological domains (none/minor/major).
- Pick rhythm (sinus or atrial fibrillation), because biomarker cutoffs differ.
- Enter BNP or NT-proBNP value to auto-assign biomarker points.
- Click calculate to get total score and interpretation.
Biomarker thresholds used in this tool
| Rhythm | Biomarker | Minor (1 point) | Major (2 points) |
|---|---|---|---|
| Sinus rhythm | BNP | 35–80 pg/mL | >80 pg/mL |
| Sinus rhythm | NT-proBNP | 125–220 pg/mL | >220 pg/mL |
| Atrial fibrillation | BNP | 105–240 pg/mL | >240 pg/mL |
| Atrial fibrillation | NT-proBNP | 365–660 pg/mL | >660 pg/mL |
Interpreting your total score
- 0–1 points: low probability of HFpEF.
- 2–4 points: intermediate probability; further testing is typically needed (for example, diastolic stress echo or invasive hemodynamics).
- 5–6 points: high probability of HFpEF.
Practical tips for better use
1) Use complete echo context
Do not assign points from one isolated measurement. Domain assignment should match a complete echocardiographic interpretation and current guideline definitions.
2) Confirm rhythm status at blood draw
Natriuretic peptides are higher in atrial fibrillation. A rhythm mismatch can overestimate or underestimate biomarker points.
3) Consider confounders
Renal dysfunction, obesity, age, and acute illness can affect biomarker levels and symptom patterns. Clinical context is essential.
4) Use the score as part of a pathway
HFpEF diagnosis is not a single-number decision. The score guides probability and next diagnostic steps, rather than replacing them.
Frequently asked questions
Is this an official diagnostic tool?
This is a web implementation of a commonly used HFpEF scoring framework. Clinical teams should always follow their local and international guidelines.
Can I use this without biomarkers?
Yes. If biomarkers are unavailable, the calculator still returns a partial score from Functional and Morphological domains, but diagnostic confidence is lower.
Does a high score guarantee HFpEF?
No. A high score indicates high probability, but diagnosis still requires clinician review and, in many cases, confirmatory testing.