Factors associated with quality of life in patients with heart failure and its impact on mortality

In heart failure (HF), patients' quality of life (QoL) is influenced not only by cardiacfunction but also by coexisting conditions. Despite the widespread use of QoL assessments, therole of patient-related factors as determinants of QoL remains not fully elucidated.

This study aims to assess the relative impact of different factors on QoL in HF patients, as well as its impact on mortality in this group.

The study was based on the national registry - HEart failuRe ObsErvational Study of the Polish Cardiac Society, in which QoL was assessed at baseline (Kansas City CardiomyopathyQuestionnaire [KCCQ]-12), and follow-up data on all-cause mortality were obtained. Adjusted linearregression was used to identify factors associated with KCCQ-12.

The study included 1397 patients with a median KCCQ-12 score of 47.92 (28.65-72.92). Higher New York Heart Association class patients had consistently lower values of all KCCQ-12domains and KCCQ-12 overall scores (85 [69-93] vs. 65 [46-79] vs. 35 [23-49] vs. 21 [10-38]; allP <0.001). Hospitalized patients had significantly lower KCCQ-12 overall score, with a significantdifference between patients hospitalized for HF or non-cardiac reasons and patients hospitalizedfor other cardiac conditions. Apart from visit type, individual factors, cardiovascular conditions, andnon-cardiac conditions were independently associated with KCCQ-12. KCCQ-12 also significantlyinfluenced all-cause mortality (hazard ratio per 1 point increase = 0.976; 95% confidence interval,0.970-0.981; P <0.001).

Individual factors with both cardiac and non-cardiac comorbidities are independentlyassociated with QoL in patients with HF. The KCCQ-12 integrates all these factors and may serve asa simple, easily accessible tool for prognostic assessment.