Document Detail


Impact of heart failure and left ventricular systolic dysfunction on quality of life: a cross-sectional study comparing common chronic cardiac and medical disorders and a representative adult population.
MedLine Citation:
PMID:  12445536     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Heart failure and left ventricular systolic dysfunction (LVSD) are increasingly common disorders, with outcomes worse than many cancers. Evidence-based therapies, such as ACE inhibitors and beta-blockers, improve prognosis and symptoms, and reduce healthcare expenditure. However, despite the high prevalence and malignant prognosis, few studies have reported the impact of heart failure and LVSD on overall quality of life and, more crucially, have not researched the elderly or those in the community. METHODS: All patients attending the Echocardiographic Heart of England Screening (ECHOES) study of the prevalence of heart failure and LVSD in the community were assessed by clinical history and examination, electrocardiogram and echocardiography, and also completed the SF36 health status questionnaire. Quality of life in patients found to have heart failure, LVSD, and other cardiac and medical conditions are compared with the randomly selected general population sample. Data are generalisable to the UK. RESULTS: 6162 people in the community were screened in the ECHOES study, of whom 5961 (97%) completed the SF36. The health perceptions of 3850 people aged 45 years or older selected randomly from the population were compared with those of 426 patients diagnosed as having definite heart failure. Those with heart failure had significant impairment of all the measured aspects of physical and mental health, in addition to declines in physical functioning. Significantly worse impairment was found in those with more severe heart failure by NYHA class: indeed, NYHA functional class was closely correlated to SF36 score. Patients with asymptomatic left ventricular dysfunction and patients rendered asymptomatic by treatment had similar scores to the random population sample. Those with heart failure reported more severe physical impairment of quality of life than people giving a history of chronic lung disease or arthritis, with less impact on mental health than patients reporting depression. CONCLUSIONS: Patients with heart failure have statistically significant impairment of all aspects of quality of life, not simply physical functioning. The physical (role and functioning) health burden was significantly greater than that suffered in other serious common chronic disorders, whether cardiac or other systems. Optimising treatment to improve NYHA class appears to improve perceptions of quality of life for patients with heart failure. Given the dramatic decline in quality of life with heart failure, this end-point should be a much more important target for healthcare interventions, especially treatments such as ACE inhibitors and beta-blockers that are shown to improve quality of life.
Authors:
F D R Hobbs; J E Kenkre; A K Roalfe; R C Davis; R Hare; M K Davies
Related Documents :
8737606 - Inotropic agents in older patients with chronic heart failure--current perspectives.
3057846 - Angiotensin converting enzyme inhibitors. ii. clinical use.
1721986 - Congestive heart failure: pathophysiology and management with special reference to syst...
11715176 - Epidemiology of heart failure.
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European heart journal     Volume:  23     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-11-26     Completed Date:  2003-04-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  1867-76     Citation Subset:  IM    
Copyright Information:
Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved
Affiliation:
Department of Primary Care and General Practice, Primary Care Clinical Sciences Building, University of Birmingham, Birmingham B15 2TT, U.K.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Aged
Chronic Disease
Cross-Sectional Studies
Female
Heart Failure / complications,  physiopathology*,  psychology
Humans
Male
Middle Aged
Prospective Studies
Quality of Life*
Questionnaires
Ventricular Dysfunction, Left / complications,  physiopathology*,  psychology
Comments/Corrections
Comment In:
Eur Heart J. 2003 Sep;24(18):1700   [PMID:  14499236 ]
Eur Heart J. 2002 Dec;23(23):1806-8   [PMID:  12445531 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  One-year mortality among unselected outpatients with heart failure.
Next Document:  Revascularization of hibernating myocardium: rate of metabolic and functional recovery and occurrenc...