Quality of life status determinants in hypertrophic cardiomyopathy as evaluated by the Kansas City Cardiomyopathy Questionnaire

Abstract

Purpose The present study evaluated how heart failure (HF) negatively impacts health-related quality of life (HRQoL) in hypertrophic cardiomyopathy (HCM) patients and explored the major clinical determinants associated with HRQoL impairment in this population. Methods This was a cross-sectional single-center study of health-related HRQoL that included 91 consecutive patients with HCM. Evaluation was performed based on a comprehensive protocol that included the recommended diagnostic studies, as well as administration of the translated validated version of the Kansas City Cardiomyopathy Questionnaire (KCCQ) (CV Outcomes Inc) as a health status measure. Results The cohort included 52 (57%) males, median age 58 (20–85) years. The median global KCCQ score was 67 (12.5–100) corresponding to a moderate impairment in HRQoL. There was an inverse correlation between the median global KCCQ score and NYHA class (Kendall’s tau b coefficient r − 0.33, p = 0.001). Patients with pulmonary hypertension (PHT), defined as resting pulmonary artery systolic pressure of ≥ 45 mmHg, presented a significantly worse HRQoL as compared to those without PHT (median KCCQ score 56.2 vs 77.5, p = 0.013). The KCCQ score mildly correlated with age (r − 0.18, p = 0.014), history of syncope (r − 0.18, p = 0.045), estimated glomerular filtration rate (eGFR) (r 0.31, p < 0.001), plasmatic creatinine (r − 0.18, p = 0.017) and urea levels (r − 0.27, p < 0.001), left ventricular (LV) end-systolic dimensions (r − 0.18, p = 0.014), maximal provoked intraventricular gradient (r 0.20, p = 0.039), LV ejection fraction (r 0.15, p = 0.04), average E/e′ (r − 0.16, p = 0.039), pulmonary acceleration time (r 0.21, p = 0.007), pulmonary artery systolic pressure (r − 0.20, p = 0.016). In ordinal regression, the independent predictors of HRQoL were NYHA class and eGFR. Conclusions Patients with HCM and HF present a moderate degree of alteration in HRQoL. This is especially true for patients with PHT and more severe functional impairment. Renal failure and NYHA class are potential markers of HRQoL in clinical practice.

Exploring experiences of hypertrophic cardiomyopathy diagnosis, treatment, and impacts on quality of life among middle-aged and older adults: An interview study

“…Past research found that patients with HCM experienced some reduction in health-related quality of life. 22 Additionally, the continuum and variability of psychological impacts after diagnosis were highlighted in our findings, including anxiety, denial, and upset feelings as well as more positive feelings of gratitude, acceptance, and increased mindfulness toward healthy habits. Past research found that patients with heart disease reported feeling different from others, 7 feeling negatively around lost health and control, 8 and experiencing anxiety around cardiac symptoms and their possible catastrophic consequences.…”

Association of Preoperative Sleep-Disordered Breathing With Functional Status After Septal Myectomy for Obstructive Hypertrophic Cardiomyopathy

“…Previous series revealed that physical limitation as categorized by NYHA class was an independent risk factor for poor quality of life. 15 Septal reduction therapy by myectomy ameliorates heart failure symptoms and can result in improved quality of life.…”

“…Previous series revealed that physical limitation as categorized by NYHA class was an independent risk factor for poor quality of life. 15 Septal reduction therapy by myectomy ameliorates heart failure symptoms and can result in improved quality of life. Previously, Wells and colleagues reported improvement in physical capacity from NYHA class III/IV to class I/II in 96% of patients after SM for obstructive HCM.…”

Quality of life and societal costs in hypertrophic cardiomyopathy: protocol of the AFFECT-HCM study

“…QoL quality of life, EQ-5D-5L EuroQol questionnaire, KCCQ Kansas City cardiomyopathy questionnaire, iMCQ medical consumption questionnaire, iPCQ productivity cost questionnaire about broader cost types [10][11][12]. Furthermore, QoL studies are rare and none have measured QoL with the EQ-5D-5L, the required instrument according to Dutch guidelines [5,[13][14][15]. The AFFECT-HCM (Quality of Life and Costs in HCM) study aims to estimate the one-year impact of HCM on generic and disease-specific QoL and the societal costs of HCM in the Netherlands.…”