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Quality of life and survival in patients with heart failure

Tialda Hoekstra1, Tiny Jaarsma, Dirk J van Veldhuisen

  • 1Department of Cardiology, University Medical Center Groningen (UMCG), University of Groningen, RB Groningen, The Netherlands. t.hoeskstra@umcg.nl

European Journal of Heart Failure
|September 20, 2012
PubMed

Insights

Quality of life significantly predicts long-term mortality in heart failure (HF) patients, independent of brain natriuretic peptide (BNP) levels. Lower scores on physical functioning and general health indicate higher mortality risk.

Area of Science:

  • Cardiology
  • Health Outcomes Research
  • Quality of Life Studies

Background:

  • Heart failure (HF) is a major cause of morbidity and mortality.
  • Predictors of long-term mortality in HF patients require further investigation.
  • The role of quality of life (QoL) in HF survival, independent of biomarkers like brain natriuretic peptide (BNP), is not fully elucidated.

Purpose of the Study:

  • To determine if self-rated disease-specific and generic QoL predict long-term mortality in HF patients.
  • To assess if this prediction is independent of BNP levels.
  • To identify factors associated with low QoL in HF.

Main Methods:

  • Prospective cohort study of 661 hospitalized HF patients.
  • Assessment of QoL using Ladder of Life, RAND36, and Minnesota Living with Heart Failure Questionnaire.
  • Measurement of BNP levels at discharge; 3-year mortality follow-up.

Main Results:

  • Three-year mortality was 42%.
  • Poor QoL scores, specifically on RAND36 physical functioning and general health dimensions, independently predicted higher mortality after adjusting for clinical and BNP variables.
  • Low QoL was associated with NYHA class III-IV, comorbidities, longer HF duration, lower eGFR, and fewer beta-blocker prescriptions.

Conclusions:

  • QoL is an independent predictor of survival in hospitalized HF patients.
  • QoL assessment provides valuable prognostic information beyond traditional clinical factors and BNP levels.
  • Identifying factors related to low QoL can inform targeted interventions to improve outcomes.
Abstract

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