Document Detail


Relationships between clinical assessments and patients' perceptions of the effects of heart failure on their quality of life.
MedLine Citation:
PMID:  16520254     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hypothetically, most of the effects of heart failure on quality of life might be attributed to symptoms produced by the pathology. Relationships between measures of these concepts need to be quantified to test this conceptual model. METHODS AND RESULTS: Measurements of heart failure pathology and symptoms and quality of life as measured by the Minnesota Living with Heart Failure (MLHF) questionnaire at the 4-month visit in the Valsartan Heart Failure Trial were analyzed. Correlation and regression analyses corrected for estimated reliability of measurements were used to quantify relationships. The percentage of variance in dependent variables that was related to explanatory variables was summarized by the coefficient of determination (100 xR(2)) from regression models. Dyspnea at rest, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, fatigue, and New York Heart Association class were significantly related to MLHF scores. Combined, these symptoms explained 41% of the variation in MLHF scores. Controlling for symptoms, age explained an additional 4.5% of the variation in MLHF scores, whereas race, gender, and available comorbidities each explained <1%. Pathologic measures including ejection fraction, B-type natriuretic peptide, jugular venous distension, rales, peripheral edema, systolic blood pressure, creatinine, and hemoglobin were not strongly related to symptom assessments (combined R(2) = 17%) or MLHF scores (combined R(2) = 7%). CONCLUSION: Symptoms of heart failure explain a substantial proportion of the variation in the effects of heart failure on patients' quality of life as measured by the MLHF score. The effects of heart failure on quality of life can vary with age independently of symptoms. Pathologic measures of heart failure including some well-known correlates of the risk of hospitalization and death are not strongly related to symptoms or quality of life. Further studies are needed to understand the relationships between heart failure pathology and symptoms and to identify determinants of the effects of heart failure on patients' quality of life that were not related to symptoms.
Authors:
Thomas S Rector; Inder S Anand; Jay N Cohn
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiac failure     Volume:  12     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-03-07     Completed Date:  2006-08-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  87-92     Citation Subset:  IM    
Affiliation:
Center for Chronic Disease Outcomes Research, Department of Veterans Affairs Medical Center, 152/2E, One Veterans Drive, Minneapolis, MN 55417, USA.
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MeSH Terms
Descriptor/Qualifier:
African Continental Ancestry Group
Age Factors
Aged
Dyspnea / physiopathology
European Continental Ancestry Group
Fatigue / physiopathology
Female
Heart Failure / classification,  physiopathology,  psychology*
Humans
Male
Middle Aged
Quality of Life*
Questionnaires
Regression Analysis

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


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