P769Quality of life in outpatients with heart failure in relation to mortality and admissions for heart failure

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Grundtvig ◽  
T Vollnes-Eriksen ◽  
T Hole
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Nyha Class ◽  
Functional Class ◽  
Physical Domain ◽  
Significant Independent Predictor ◽  
Nyha Functional Class ◽  
Daily Dose

Abstract Studies report relation between quality of life and outcome. However, less is known about how various aspects of quality of life relates to mortality and admissions for heart failure. Method Mortality was examined in 7001 patients with completed Minnesota Living with Heart Failure Questionnaire (MLWHFQ) at the first visit to specialised hospital outpatient clinics included in our registry. A subset of 4264 patients with a second MLWHFQ at a late follow-up visit was assessed for the number of admissions and days in hospital for reason of heart failure during a six months period prior to the late visit. Results In multivariate Cox proportional hazard regression model for time to death after the first visit with a median 19 months follow-up and 1001 deaths, the MLWHFQ score for the subset of the “physical domain” (question 2 to 9) was a significant independent predictor for mortality (P=0.002) adjusted for gender, NYHA-class, blood pressure, s-sodium, stroke, obstructive lung disease, eGFR, anemia, age, daily dose diuretic, and ischemic cause for heart failure. The total MLWHFQ score and the Minnesota “emotional domain” (question 17–21) were not significant variables when the MLWHFQ “physical domain” was entered in the analysis. The number of admissions for heart failure and the number of days in hospital for these admissions in a six months period prior to the late visit were analysed by linear regression for related variables. The total MLWHFQ score at the late visit was highly significant for the number of admissions in the six months period (p<0.001) adjusted for the daily dose diuretic, NYHA functional class and proBNP. The MLWHFQ “physical domain” and the MLWHFQ “emotional domain” were not significant variables when the total score was entered. The number of days in hospital was related to the daily dose diuretic, NYHA functional class, proBNP, and in addition anaemia at the late visit again with the MLWHFQ total score being a significant predictor (=0.001) Conclusions Disease specific quality of life measured with MLWHFQ “physical domain” was a highly significant predictor for mortality after the first visit. The late total MLWHFQ score was a better predictor for heart failure related admissions and days in hospital than the subset domains in multivariate analysis. Acknowledgement/Funding None

scholarly journals Effects of Oral Amino Acid Supplements on Functional Capacity in Patients with Chronic Heart Failure

2014 ◽  
Vol 8 ◽  
pp. CMC.S14016 ◽  
Author(s):  
Carlo Lombardi ◽  
Valentina Carubelli ◽  
Valentina Lazzarini ◽  
Enrico Vizzardi ◽  
Filippo Quinzani ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
New York ◽  
Functional Capacity ◽  
Exercise Tolerance ◽  
Stress Test ◽  
Nyha Class ◽  
Heart Association

Amino acids (AAs) availability is reduced in patients with heart failure (HF) leading to abnormalities in cardiac and skeletal muscle metabolism, and eventually to a reduction in functional capacity and quality of life. In this study, we investigate the effects of oral supplementation with essential and semi-essential AAs for three months in patients with stable chronic HF. The primary endpoints were the effects of AA's supplementation on exercise tolerance (evaluated by cardiopulmonary stress test and six minutes walking test (6MWT)), whether the secondary endpoints were change in quality of life (evaluated by Minnesota Living with Heart Failure Questionnaire—MLHFQJ and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. We enrolled 13 patients with chronic stable HF on optimal therapy, symptomatic in New York Heart Association (NYHA) class II/III, with an ejection fraction (EF) <45%. The mean age was 59 ± 14 years, and 11 (84.6%) patients were male. After three months, peak VO2 (baseline 14.8 ± 3.9 mL/minute/kg vs follow-up 16.8 ± 5.1 mL/minute/kg; P = 0.008) and VO2 at anaerobic threshold improved significantly (baseline 9.0 ± 3.8 mL/minute/kg vs follow-up 12.4 ± 3.9 mL/minute/kg; P = 0.002), as the 6MWT distance (baseline 439.1 ± 64.3 m vs follow-up 474.2 ± 89.0 m; P = 0.006). However, the quality of life did not change significantly (baseline 21 ± 14 vs follow-up 25 ± 13; P = 0.321). A non-significant trend in the reduction of NT-proBNP levels was observed (baseline 1502 ± 1900 ng/L vs follow-up 1040 ± 1345 ng/L; P = 0.052). AAs treatment resulted safe and was well tolerated by all patients. In our study, AAs supplementation in patients with chronic HF improved exercise tolerance but did not change quality of life.

scholarly journals Psychosocial adaptation to chronic heart failure in patients with coronary heart disease

2021 ◽  
Vol 102 (2) ◽  
pp. 156-166
Author(s):  
A G Zhidyaevskij ◽  
G S Galyautdinov ◽  
V D Mendelevich ◽  
A G Gataullina ◽  
A O Kuzmenko
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Psychosocial Adaptation ◽  
Functional Class ◽  
Adherence To Treatment ◽  
Nyha Functional Class ◽  
Type D ◽  
Sf 36

Aim. To assess the effects of acquired social status, neurotic conditions, type D personality, cognitive functions, quality of life and adherence to treatment on psychosocial adaptation of patients with coronary heart disease (IHD) to chronic heart failure (CHF), depending on the severity of decompensation. Methods. 87 patients with coronary artery disease and chronic heart failure aged between 55 and 72 years were examined. All patients were divided into two groups depending on the functional class of chronic heart failure [New York Heart Association (NYHA) class IIV]. The first group included 41 patients with NYHA functional class III, the second group 46 patients with NYHA functional class IIIIV. For a comprehensive study of the psychosocial adaptation of patients, a set of standardized questionnaires was used: the abridged variant of the Minnesota Multiphasic Personality Inventory (SMOL), a clinical questionnaire for identifying and assessing neurotic condition, the Minnesota Living with Heart Failure Questionnaire (MLHFQ), the 36-Item Short Form Health Survey Questionnaire (SF-36), the Mini Mental State Examination (MMSE), 14-question test Type D Scale-14 (DS14), MoriskyGreen test, the short version of the AUDIT questionnaire (AUDIT-C). We collected data on the patient's social status: gender, education, income level. The results obtained were analyzed. Results. Based on the SMOL personality profiles, patients of the second group were classified as neurotic an increase was noted in three neurotic scales: hypochondria (U=541; p=0.030), hysteria (U=579; p=0.048), and autism/schizoid (U=577.5; p=0.047) compared with patients of the first group. According to the results of the clinical questionnaire for the identification and assessment of neurotic condition, the greatest differences were found between patients of first and second groups on the scale of autonomic disorders (U=571; p=0.039) and neurotic depression (U=576; p=0.046). Comparing the groups according to the MLHFQ score, quality of life in patients of the second group was markedly reduced (U=447.5; p 0.001). According to the SF-36 questionnaire, a decrease in the quality of life was also found in patients of the second group on the scale Physical functioning (U=554; p=0.032) and Physical component of health (U=573.5; p=0.044). The cognitive status in patients of the second group was significantly decreased compared with the first group (U=427; p 0.001). No significant differences were found in adherence to treatment between the two groups (U=757; p=0.666). Also, there were no patients with type D personality on both subscales (U=717.5; p=0.483, U=784; p=0.933) and according to the AUDIT-C scores, there are no significant differences between men (U=681.5; p=0.257) and women (U=728.5; p=0.425) in both groups of patients. Conclusion. Signs of social maladjustment in patients with more severe NYHA functional class of the disease are expressed by significantly more pronounced social isolation (autism), a tendency to avoid communicating with others, isolation on their own problems and hypochondriacal attention to the somatic manifestations of chronic heart failure; probably, the main reason that reduces the level of social adaptation is a high score in neuroticism, which leads to a functional decrease in cognitive abilities and a significant deterioration in quality of life.

Abstract 2234: Self-care And Quality Of Life In Patients With Heart Failure

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Chantira Chiaranai ◽  
Jeanne Salyer
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Decision Making ◽  
Self Care ◽  
Functional Class ◽  
Nyha Functional Class ◽  
Co Morbidity ◽  
Patients With Heart Failure ◽  
Disease Specific

Purpose: Although it is well-known that self-care (SC) reduces the frequency of hospital admissions and exacerbations, and enhances quality of life (QOL) in heart failure patients, little is known about SC in this population. The study purpose was to examine relationships among selected individual characteristics (demographics, severity of illness, co-morbidities, and social support), SC strategies, and QOL using Reigel’s Model of Self Care in Patients with Heart Failure as the guiding framework. Method: 114 subjects were recruited to participate in this descriptive correlational study. SC was measured using the Self-Care of Heart Failure Index , which measures self-care maintenance (SC-Mt), self-care management (SC-Mn), and self-care self-confidence (SC-Sc). QOL was measured using a disease-specific instrument, the Minnesota Living with Heart Failure Questionnaire , and a generic instrument, the Short-Form Health Survey characterizing physical and mental-emotional functioning. Multiple regression analysis was used to identify predictors of QOL. Findings: 98 subjects (age = 56.7 years; 53.8% male; 49.5% Caucasian) completed and returned mailed questionnaires. Multiple regression analyses demonstrated that better disease-specific QOL was predicted by being less likely to try SC-Mn strategies (β = .325; p = 0.003), better SC-Sc (β = −.251; p = 0.012), better NYHA functional class (β = .246; p = 0.008), and less co-morbidity (β = .236; p = 0.014) (R 2 = .334; F = 7.269, p = 0.000). Better generic QOL (physical functioning) was predicted by better NYHA functional class (β = −.309; p = 0.001), better SC-Mt (β = .205; p = 0.037), better SC-Sc (β = .296; p = 0.003), and being less likely to try SC-Mn strategies (β = −.165; p = 0.000) (R 2 = .361; F = 9.602, p = 0.000). Better generic QOL (mental-emotional functioning) was predicted by better NYHA functional class (β = −.229; p = 0.024), and being men (β = −.204; p = .047) (R 2 = .277; F = 4.548, p = 0.000). Discussion: Findings suggest that better QOL is influenced by gender (male), better NYHA functional class, less co-morbidity, and better use of SC strategies. Exploring patient decision-making can assist nurses in identifying how to improve decision-making performance and enhance QOL.

scholarly journals Vagal Neuromodulation in Chronic Heart Failure With Reduced Ejection Fraction: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Lucas Bonacossa Sant'Anna ◽  
Sérgio Lívio Menezes Couceiro ◽  
Eduardo Amar Ferreira ◽  
Mariana Bonacossa Sant'Anna ◽  
Pedro Rey Cardoso ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Systematic Review ◽  
Chronic Heart Failure ◽  
Meta Analysis ◽  
Functional Class ◽  
Walk Test ◽  
Reduced Ejection Fraction ◽  
Nyha Functional Class

Objectives: The aim of this study was to evaluate the effects of invasive vagal nerve stimulation (VNS) in patients with chronic heart failure (HF) and reduced ejection fraction (HFrEF).Background: Heart failure is characterized by autonomic nervous system imbalance and electrical events that can lead to sudden death. The effects of parasympathetic (vagal) stimulation in patients with HF are not well-established.Methods: From May 1994 to July 2020, a systematic review was performed using PubMed, Embase, and Cochrane Library for clinical trials, comparing VNS with medical therapy for the management of chronic HFrEF (EF ≤ 40%). A meta-analysis of several outcomes and adverse effects was completed, and GRADE was used to assess the level of evidence.Results: Four randomized controlled trials (RCT) and three prospective studies, totalizing 1,263 patients were identified; 756 treated with VNS and 507 with medical therapy. RCT data were included in the meta-analysis (fixed-effect distribution). Adverse effects related to VNS were observed in only 11% of patients. VNS was associated with significant improvement (GRADE = High) in the New York Heart Association (NYHA) functional class (OR, 2.72, 95% CI: 2.07–3.57, p &lt; 0.0001), quality of life (MD −14.18, 95% CI: −18.09 to −10.28, p &lt; 0.0001), a 6-min walk test (MD, 55.46, 95% CI: 39.11–71.81, p &lt; 0.0001) and NT-proBNP levels (MD −144.25, 95% CI: −238.31 to −50.18, p = 0.003). There was no difference in mortality (OR, 1.24; 95% CI: 0.82–1.89, p = 0.43).Conclusions: A high grade of evidence demonstrated that vagal nerve stimulation improves NYHA functional class, a 6-min walk test, quality of life, and NT-proBNP levels in patients with chronic HFrEF, with no differences in mortality.

scholarly journals Quality of life related to health for heart failure patients

2019 ◽  
Vol 72 (suppl 2) ◽  
pp. 140-146 ◽  
Author(s):  
Larissa Ferreira de Araújo Paz ◽  
Carolina de Araújo Medeiros ◽  
Silvia Marinho Martins ◽  
Simone Maria Muniz da Silva Bezerra ◽  
Wilson de Oliveira Junior ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Chagas Disease ◽  
Functional Class ◽  
Heart Failure Patients ◽  
Emotional Dimension ◽  
Heart Failure Questionnaire ◽  
Transversal Study

ABSTRACT Objective: To assess the quality of life related to health for heart failure patients and to relate sociodemographic and clinical data. Method: It is an observational and transversal study, with quantitative approach, carried out in a heart failure ambulatory in the state of Pernambuco. Results: In the sample (n=101), there was prevalence of men older than 60 years old, married and professionally inactive. The quality of life related to health, based on the Minnesota Living With Heart Failure Questionnaire, was considered moderate (34.3±21.6), being significantly related to age (p=0.004), functional class (p<0.001), and patients with chagasic cardiopathy (p=0.02). Conclusion: The quality of life in the HF group of chagasic etiology was more compromised, specially in the emotional dimension. It is suggested that studies on the hypothesis that longer ambulatory follow-up improves quality of life and that having Chagas disease interferes negatively with the quality of life of heart failure patients.

scholarly journals Clinical effects of the enhanced external counterpulsation therapy in patients with ischemic chronic heart failure exacerbation COVID-19

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
I Shashenkov ◽  
S.A Gabrusenko ◽  
S.L Babak ◽  
A.G Maliavin
Keyword(s):  
Heart Failure ◽  
Treatment Group ◽  
Chronic Heart Failure ◽  
Nyha Class ◽  
Functional Class ◽  
Clinical Effects ◽  
External Counterpulsation ◽  
Nyha Functional Class ◽  
Enhanced External Counterpulsation

Abstract Objectives The aim of the study was to assess the effects of the enhanced external counterpulsation (EECP) therapy as a rehabilitation method in patients with ischemic chronic heart failure (CHF) after COVID-19. Methods 54 (n=54) stable symptomatic CHF (NYHA, functional class I-II; 35%≤LVEF≤50%) subjects (44 male and 10 female; mean age 61±9,8) with prior anamnesis of CAD, at least one myocardial infarction got the exacerbation of CHF after COVID-19 episode. They were randomized in a 2:1 manner into either 35 1-hour 250–300 mm Hg sessions of EECP (n=36; 30 male, 6 female) or Sham-EECP (n=18; 14 male, 4 female). All subjects had been received optimal CHF and CAD drug therapy. At baseline, a month and half a year after EECP course every subject was examined with echocardiography and 6-minute walk test. Results All 36 active EECP treatment group subjects improved by at least 1 NYHA class, 66% of them had no heart failure symptoms post treatment (p&lt;0.01). 84% of treatment group pts. had sustained NYHA class improvement at half a year follow-up (p&lt;0.01), compared with baseline. There was significant difference between LVEF 44±6,5% at baseline vs post-EECP LVEF 50±4,6% (p&lt;0.01) in active EECP treatment group subjects. At the same time there were no significant changes of NYHA class and LVEF in Sham-EECP subjects. No one subject dies after half a year of follow up. Conclusions Enhanced external counterpulsation (EECP) therapy sustainably improves NYHA functional class and LVEF in patients with ischemic CHF exacerbation after COVID-19. FUNDunding Acknowledgement Type of funding sources: None.

Anxiety and Coping Based on Emotions may contribute to Reduced Quality of Life in Patients with Mild Systolic Heart Failure

2018 ◽  
pp. 1-6
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Self Efficacy ◽  
Sense Of Self ◽  
Coping Styles ◽  
Nyha Class ◽  
Systolic Heart Failure ◽  
Emotional Dimension ◽  
And Coping

Aims and Scope: Perception of health related quality of life (QoL) may result from the complex interplay between the severity of the disease and the patient’s psyche. It the present study we assumed that anxiety and coping based on emotions may contribute to reduced QoL in patients with mild systolic heart failure (HF). Methods: We examined mainly males with systolic HF (almost all with ischemic etiology of HF, all classified in the NYHA class II, receiving standard pharmacological treatment). Each patient underwent a physical examination, routine laboratory tests and standard transthoracic echocardiography and completed psychological questionnaires assessing: coping styles, sense of self efficacy, acceptance of illness, optimism and the level of anxiety and QoL (by Minnesota Living with Heart Failure Questionnaire). Results: Emotion-oriented coping was strongly positively related to an overall score reflecting QoL (r=0.37) as well as to both dimensions of QoL, with exceptionally high correlation with the emotional dimension (r=0.24 and r=0.62, respectively, all p<0.05). More reduced QoL (overall score as well as scores in both analysed dimensions) was significantly (all p<0.05) but weakly (r=-0.21, r=-0.20 and r=-0.26, respectively) related to lower acceptance of the illness. Higher level of anxiety was related to more reduced QoL (all p<0.05). Reduced QoL in emotional dimension was related to the tendency to avoidance-oriented coping (r=0.26, including also a sub style based on distraction, r=0.34) as well as to lower sense of self-efficacy (r=-0.20) and lower level of optimism (r=-0.20, all p<0.05). Conclusion: The results indicate that HF patients are psychologically diverse, which is not related to disease severity. However, QoL was related to emotion-oriented coping and anxiety. Psychological support for patients with HF should be focused on teaching adequate methods of coping and reducing anxiety.

Abstract 11916: Changes in Symptoms Predicted Changes in Health-Related Quality of Life in Patients With Heart Failure

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Seongkum Heo ◽  
Debra K Moser ◽  
Terry A Lennie ◽  
Mary Fischer ◽  
Eugene Smith ◽  
...  
Keyword(s):  
Heart Failure ◽  
Self Care ◽  
Physical Symptoms ◽  
Functional Class ◽  
Nyha Functional Class ◽  
Behavioral Variables ◽  
Patients With Heart Failure ◽  
Related Quality ◽  
Health Related

Background: Patients with heart failure (HF) have notably poor health-related quality of life (HRQOL), which is associated with high hospitalization rates. Physical symptoms have been associated with poor HRQOL. However, whether improvement in physical symptoms actually leads to improvement in HRQOL has not fully examined in patients with HF. Purpose: To examine the effects of changes in physical symptoms on changes in HRQOL at 12 months, after controlling for age, comorbidities, New York Heart Association (NYHA) functional class, and modifiable psychosocial and behavioral factors. Methods: Data on physical symptoms (Symptom Status Questionnaire-HF) and HRQOL (Minnesota Living with Heart Failure) were collected from 94 patients with HF (mean age 58 ± 14 years, 44% male, 58% NYHA functional class II/III) at baseline and 12 month follow-up. Age, comorbidities, and NYHA functional class were collected using standard questionnaires at baseline. Psychosocial variables (depressive symptoms [Patient Health Questionnaire], perceived control [Control Attitudes Scale-Revised], and social support [Multidimensional Scale of Perceived Social Support]) and behavioral variables (medication adherence [Micro-Electro-Mechanical Systems], sodium intake [24-hour urine], and self-care management [Self-care management subscale of the Self-Care of Heart Failure Index]) were collected at baseline. Hierarchical multiple regression analyses were used to analyze the data. Results: The mean score changes in physical symptoms and HRQOL were -3.8 (± 14.1) and -9.2 (± 24.1), respectively (negative scores indicate improvement.). Among the sociodemographic and clinical characteristics, psychosocial variables, behavioral variables, baseline physical symptoms, and changes in physical symptoms, only changes in physical symptoms predicted changes in HRQOL at 12 months (F = 6.384, R2 = .46, p < .001). Improvement in physical symptoms led to improvement in HRQOL. Conclusion: It is critical to improve physical symptoms to improve HRQOL. Thus, development and delivery of effective interventions targeting improvement in physical symptoms are warranted in this population.

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