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ASSESSING QUALITY OF LIFE IN PATIENTS WITH HEART FAILURE: WHAT’S THE SECRET?

Abstract

BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is the fastest growing form of heart failure in the United States. Studies have shown that interventions, such as supervised exercise training, can be beneficial to the quality of life (QOL) of patients with HFpEF. However, data from SECRET 1 suggests that several widely used QOL instruments can lead to different conclusions regarding the QOL in older adults with obese HFpEF. The present study further investigates the relationship of these QOL instruments and the subsequent impact on patient classification. METHODS: Data was obtained from the Minnesota Living with Heart Failure Questionnaire (MLHF), the Kansas City Cardiomyopathy Questionnaire (KCCQ), and Short-Form 36 (SF-36) were obtained at baseline on 104 SECRET 1 study participants. Descriptive statistics were performed, and SPSS was used to perform t-test, 1-way ANOVA, and 2-proportion z-test. RESULTS: The overall QOL values on MLHF vs. KCCQ at baseline were statistically different (40+8 vs. 65+9, respectively; p= 0.001). Furthermore, the physical function subscale of the MLHF, KCCQ, and SF-36 were also significantly different. at baseline in these subjects. For QOL classifications, the number of individuals classified by the MLHF and KCCQ as “very poor-poor” and “poor-fair” QOL were not significantly different, however the number of those classified as “fair-good” (36 vs. 57, respectively) and “good-excellent” (42 vs. 22, respectively) QOL classifications were significantly different. CONCLUSION: In these older patients with obese HFpEF, the three widely used QOL instruments did lead to different results and patient classifications. This may result in provider mismanagement and treatment of patients based on which QOL instrument is used. Further research is required to determine which is the optimal QOL instruments to use in this patient population.

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