Characterization of health‐related quality of life in heart failure patients with preserved versus low ejection fraction in CHARM

Abstract

Background: Limited comparative studies assessing the health-related quality of life (HRQL) in heart failure (HF) patients with preserved vs. low ejection fraction (LVEF) have been disparate. Aims: The aims of this study were a) to characterize HRQL in a large population of HF patients with preserved and low LVEF and b) to determine the factors associated with worse HRQL. Methods: Patients with symptomatic HF (NYHA Class II-IV) enrolled in the Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) HRQL study completed the Minnesota Living with Heart Failure questionnaire at randomization. Patients were stratified into 2 HF cohorts: preserved LVEF (N 40%) and low LVEF (≤40%). Results: In 2709 of the eligible 2744 (98.6%) patients, the summary scores ranged from 0 to 105 (mean 40.9). There were no differences in overall responses of HF patients with preserved vs. low LVEF (41.1 vs. 40.8). Independent factors associated with worse HRQL in both populations included female gender, younger age, higher body mass index, lower systolic blood pressure, greater symptom burden, and worse functional status. Conclusions: In symptomatic HF patients, HRQL is equally impaired in both preserved and low LVEF populations. Targeting improvement in symptoms and HRQL is an important treatment objective in all HF patients.

Are There Any Significant Differences Between Females and Males in the Management of Heart Failure? Gender Aspects of an Elderly Population With Symptoms Associated With Heart Failure

“…The differences in perceived symptoms reported by females could be explained by the possibility that male physicians have difficulties interpreting the symptom panorama presented by female patients, as discussed above. On the other hand, it is also possible that female patients who might exhibit worse health-related quality of life express this in physical symptoms that are more difficult to interpret correctly [26]. The Kaplan-Meir analysis based on the total study population also found that the female group, despite sometimes displaying more symptoms, has a lower mortality risk of cardiovascular death than their male counterparts.…”

Medida do impacto da doença: validade de constructo de instrumento entre coronariopatas

“…performance indices point to an absence of consensus regarding the association between lower HRQoL and decreased LVEF; the results showed worsened HRQoL in both situations, i.e., in patients with normal LVEF and those with decreased LVEF (19)(20) . However, the data suggested that the IDCV was sensitive enough to detect differences in the impact of the disease in patients who scored in different quartiles of general and specific measures of the HRQoL.…”

Approach to the Treatment of Heart Failure With Preserved Ejection Fraction and Mid- Range Ejection Fraction

“…Thus, the ESC guidelines indicate as the goal of therapy in HFpEF/HFmrEF the relief of symptomatology and the consequential improvement in quality of life. [3] In fact, patients in these categories are often elderly and present worse symptomatology, more comorbidities and poorer prognosis than HFrEF patients. [4,1] In order to alleviate symptoms/signs, the ESC guidelines recommend the use of diuretics to improve congestion in HFpEF/ HFmrEF patients.…”