Assessing Quality of Life and Its Predictors in Patients with Heart Failure with Reduced Ejection Fraction: A Single-Center, Cross-Sectional Study in Bangladesh

Introduction: Heart failure significantly impairs quality of life, yet data on the patient experience, particularly from low- and middle-income countries like Bangladesh, are scarce. Understanding the key drivers of poor HRQoL is essential for developing effective, patient-centered management strategies. This study aimed to assess health-related quality of life (HRQoL) and identify its associated sociodemographic and clinical factors among patients with heart failure with reduced ejection fraction (HFrEF) in Bangladesh. Methods: We conducted a prospective, single-center, cross-sectional study at a tertiary care hospital in Dhaka. A total of 800 patients with a confirmed diagnosis of HFrEF were enrolled. HRQoL was measured using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Sociodemographic, clinical, biochemical, and echocardiographic data were collected. A multiple linear regression model was used to identify independent factors associated with HRQoL scores. Results: The mean total MLHFQ score was 46.12 ± 26.06, with 43.3% of patients reporting poor HRQoL. In the multivariable analysis, poorer HRQoL was significantly associated with older age, being single or widowed, lower income, higher NYHA functional class, recent hospitalization, atrial fibrillation, and moderate or severe pulmonary hypertension. Conversely, higher systolic blood pressure and longer duration of HF were associated with better HRQoL scores. The final model explained a significant portion of the variance in total HRQoL (Adjusted R² = 0.879). Conclusion: A large proportion of HFrEF patients in this Bangladeshi cohort experience poor health-related quality of life. Both clinical severity and sociodemographic factors are strong determinants of patient well-being. These findings underscore the need to integrate routine HRQoL assessment and address social determinants of health within heart failure management programs in the region.