Influence of baseline parameters on one‐year physical, mental, and health‐related quality of life in patients with heart failure and preserved ejection fraction

Abstract

Aims To identify baseline parameters longitudinally influencing overall health‐related quality of life (HRQoL), physical function and mental health 1 year later in patients with chronic heart failure and preserved ejection fraction (HFpEF). Methods and results We performed post hoc analyses of the randomized aldosterone in diastolic heart failure (Aldo‐DHF) trial, including 422 patients with HFpEF and NYHA class II or III. Overall HRQoL, measured by the Minnesota Living with Heart Failure Questionnaire (MLHFQ), physical functioning and mental health, both measured by the Short Form 36 Health Survey (SF‐36), after 12 months were predicted in correlation analyses and multivariate regression analyses with continuous values and worst versus three better HRQoL quartiles as dependent variables. The mean age of the study population was 66.8 ± 7.6 years, 52.4% were female, and 86.0% had NYHA class II. All HRQoL variables at 1 year were predicted by their respective baseline values (all P < 0.001), which were also the best variables to predict lowest versus higher HRQoL quartiles (all P < 0.001). For overall HRQoL, six‐minute‐walking‐distance (P = 0.009), Borg‐score (P = 0.001), coronary heart disease (P = 0.036) and SF‐36 role‐emotional (P = 0.005) independently predicted one‐year‐outcome, while depression diagnosis (P = 0.044), self‐reported health status (P = 0.023) and PHQ depression (P = 0.001) were only significant predictors when excluding MLHFQ total score at baseline. In logistic regression analyses, only SF‐36 role‐emotional (P = 0.016) independently predicted overall HRQoL group status at follow up. For physical functioning, Borg‐score (P ≤ 0.001), 6 min walking distance (P = 0.005), coronary heart disease (P = 0.009), and SF‐36 vitality (P = 0.001) were significant independent predictors, also when excluding baseline physical functioning. Low SF‐36 vitality (P = 0.021) and presence of coronary heart disease (P = 0.027) independently predicted a patient's membership in the lowest quartile 1 year later. For mental health, SF‐36 physical functioning (P = 0.025) and HADS anxiety (P = 0.046) were independent predictors, while self‐rated fatigue and poor performance (P = 0.033) and SF‐36 vitality (P = 0.008) only served as significant predictors when excluding mental health at baseline. HADS anxiety (P = 0.009) also served as independent predictor of a patient's group status after 1 year. Conclusion Overall HRQoL, physical functioning, and mental health of HFpEF patients 1 year later are mainly influenced by their respective baseline values. Other self‐rated baseline parameters also showed independent effects while objective severity measures had limited predictive value.

Safety and Efficacy of Sacubitril/Valsartan in Patients With a Failing Systemic Right Ventricle: A Prospective Single-Center Study

“…Patients were reviewed at 4 time points: 1-, 3-, 6-, and 12-month after treatment initiation. Baseline evaluation included the following: ECG, physical examination, NYHA class assessment, echocardiography, 6-minute walking test, blood samples, and assessment of QoL, using the Short Form-36 Health Survey 12 in which a score between 0 and 100 may be reached for each subscale, with higher scores indicating better QoL. Patients on at least 80 mg valsartan daily or equivalent dosage of ACEi/ARB were started on sacubitril/valsartan 49/51 mg BID, while those on lower dosage were started on sacubitril/valsartan 24/26 mg BID.…”

“…Patients on at least 80 mg valsartan daily or equivalent dosage of ACEi/ARB were started on sacubitril/valsartan 49/51 mg BID, while those on lower dosage were started on sacubitril/valsartan 24/26 mg BID. 16 ACEi/ARB were discontinued 36 hours before treatment initiation. Dose adjustments were performed at each follow-up visit.…”

Efficacy of Xinbao pill on chronic heart failure: Study protocol of a multicenter, randomized, double-blind, placebo-controlled trial

“…1) cardiac function classification (NYHA) ( Yancy et al, 2013 ); 2) the 6-minute walking distance test (6MWT) ( Ingle et al, 2005 ); 3) the Minnesota Living with Heart Failure Questionnaire score ( Fitz et al, 2021 ); 4) the rate of endpoint events (acute exacerbation rehospitalization of CHF, cardiac death and all-cause death, etc. ); 5) serum NT-proBNP level; 6) cardiac function indicators, such as the left ventricular ejection fraction (LVEF), the left ventricular end-diastolic diameter (LVEDD), and the left ventricular end-systolic diameter (LVESD); and 7) TCM symptom scores (Supplementary material 1) will be used to quantify the symptoms.…”

Psychometric assessment of patients with congestive heart failure by using hospital anxiety and depression scale

“…Overall, previous studies have emphasized the high prevalence, adverse impact, and potential clinical implications of depression and anxiety symptoms in CHF patients [19]. Further research is needed to explore optimal screening methods, effective interventions, and strategies for improving the integration of mental health care into the management of CHF [20].…”