TABLE 1

Pre-test probability of left heart disease (LHD) phenotype

FeatureHigh probabilityIntermediate probabilityLow probability
Age>70 years60–70 years<60 years
Obesity, systemic hypertension, dyslipidaemia, glucose intolerance/diabetes>2 factors1–2 factorsNone
Previous cardiac intervention#YesNoNo
Atrial fibrillationCurrentParoxysmalNo
Structural LHDPresentNoNo
ECGLBBB or LVHMild LVHNormal or signs of RV strain
EchocardiographyLA dilation; grade >2 mitral flowNo LA dilation; grade <2 mitral flowNo LA dilation; E/e′ <13
CPETMildly elevated V′E/V′CO2 slope; EOVElevated V′E/V′CO2 slope or EOVHigh V′E/V′CO2 slope; no EOV
Cardiac MRILA strain or LA/RA >1No left heart abnormalities

LBBB: left bundle branch block; LVH: left ventricular hypertrophy; RV: right ventricular; LA: left atrial; E/e′: early mitral inflow velocity/mitral annular early diastolic velocity ratio; CPET: cardiopulmonary exercise testing; V′E: minute ventilation; V′CO2: carbon dioxide production; EOV: exercise oscillatory ventilation; MRI: magnetic resonance imaging; RA: right atrial. #: coronary artery and/or valvular surgical and/or non-surgical procedures, including percutaneous interventions.