Heart Lung Circ. 2026 Feb 13:S1443-9506(25)01689-0. doi: 10.1016/j.hlc.2025.10.007. Online ahead of print.
ABSTRACT
BACKGROUND: Health-related quality of life (HRQoL) is an important clinical measure in heart failure (HF), but little is known about the factors associated with changes in HRQoL.
METHOD: This is a prospective, single-centre study of patients with HF who completed the Kansas City Cardiomyopathy Questionnaire (KCCQ-23) to assess HRQoL at baseline and 6-months follow-up. Patients were categorised into baseline KCCQ-Clinical Symptom Score (CSS) tertiles and compared for their baseline to 6-month change. Factors associated with baseline to a 6-month change in KCCQ-CSS were determined by multivariable ordered logistic regression. Other KCCQ domains were studied as secondary outcomes.
RESULTS: We included 246 patients, 32% women, mean age 73±11 years and mean left ventricular ejection fraction of 34±16%. Factors independently associated with worsening KCCQ-CSS at 6 months were higher potassium levels (odds ratio [OR] 1.6; 95% confidence interval [CI] 1.0-2.7 per 1 mmol/L increase in potassium), being retired (OR 2.1; 95% CI 1.2-3.5), a history of stroke (OR 3.2; 95% CI 1.6-6.5), and follow-up duration >1 year (OR 1.7; 95% CI 1.0-2.7). Conversely, smoking cessation was associated with KCCQ-CSS improvement (OR 0.5; 95% CI 0.3-0.8). KCCQ-CSS, total symptom score, and overall summary score was well correlated (Rho≥0.9) with similar results across KCCQ domains.
CONCLUSIONS: Factors associated with HRQoL changes included clinical and social aspects. While some factors, such as smoking cessation, can be targeted for intervention, others-like potassium levels, employment status, and stroke-reflect underlying disease progression or demographic characteristics. HRQoL in HF is likely influenced by a multitude of factors, underscoring the importance of a multifactorial management approach.
PMID:41690873 | DOI:10.1016/j.hlc.2025.10.007