Key result
High-comorbidity HF links to the worst baseline quality of life but greatest 12-month quality of life improvement.
Why the study?
Grouping comorbidities can better reflect the intrinsic relationships among complications, prompting an exploration of relationships between comorbidity groups and dynamic changes in HRQoL in chronic heart failure.
Do different comorbidity clusters affect the dynamic changes in health-related quality of life in patients with chronic heart failure?
Observational (n=1,533)
Yes
Do different comorbidity clusters affect the dynamic changes in health-related quality of life in patients with chronic heart failure?
In patients with chronic heart failure, distinct comorbidity clusters significantly impact baseline quality of life and its trajectory, with the highest comorbidity burden group experiencing the worst baseline status but the greatest improvement over 12 months.
Answers are grounded in this paper and cite their sources.
May guide comorbidity-based HRQoL monitoring in HF; hypothesis-generating and should not yet change practice.
Purpose: Grouping comorbidities can better reflect the intrinsic relationships among complications. We aimed to explore the relationships between comorbidity groups and dynamic changes in health-related quality of life (HRQoL) in patients with chronic heart failure (CHF). Patients and Methods: A total of 1533 patients with CHF were included. Demographic and clinical variables were recorded during hospitalization. HRQoL was assessed using the Kansas City Cardiomyopathy Questionnaire (KCCQ) at baseline and at 3 and 12 months. Latent class analysis was used to identify comorbidity groups among patients with CHF. This method identifies latent subgroups by analyzing patterns in their comorbidities. Repeated-measures analysis of variance (ANOVA) was used to assess the relationships between comorbidity groups and dynamic changes in KCCQ scores. Results: Three comorbidity clusters were identified: the young/valvular heart disease (VHD) group, the elderly/coronary heart disease (CHD) group, and the high-comorbidity burden group. The young group had a relatively lower comorbidity burden and the best HRQoL, followed by the elderly/CHD group, while the high-comorbidity burden group showed the worst HRQoL. The overall summary scores, clinical summary scores, social limitations, physical limitations, and self-efficacy were significantly highest in the high-comorbidity burden group. In addition, at 3 months the symptom scores had decreased in all three groups. Repeated-measures ANOVA showed that the comorbidity groups were significantly associated with dynamic changes in HRQoL through time and group effects. Conclusion: There were significant differences in the baseline characteristics and dynamic changes of HRQoL among different comorbidity clusters. Patients in the high-comorbidity burden group performed the worst in terms of quality of life, but the improvement was the most significant.
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Zhang et al. (2026) conducted an observational in Chronic Heart Failure (n=1,533). Comorbidity group classification by Latent Class Analysis into three groups: young/valvular heart disease group, elderly/coronary heart disease group, and high-comorbidity burden group was evaluated on Health-related quality of life assessed by Kansas City Cardiomyopathy Questionnaire (KCCQ) overall summary scores and domain scores across comorbidity clusters and over time (Significant differences in baseline KCCQ overall summary scores among clusters (P=0.035), with high-comorbidity burden group having lowest baseline HRQoL; repeated-measures ANOVA showing significant time effect (P<0.001) and group effect (P=0.041) on KCCQ overall summary scores, 95% CI High-comorbidity burden group baseline KCCQ-OS 52.27 (95% CI 49.22–55.32); Elderly/CHD group 56.77 (55.38–58.15); Young/VHD group 55.84 (53.96–57.73), p=0.035 for baseline KCCQ-OS difference; <0.001 for time effect on KCCQ scores; 0.041 for group effect on KCCQ-OS in repeated measures ANOVA). Patients with chronic heart failure in the high-comorbidity burden group had the worst baseline quality of life but showed the most significant improvement over 12 months, while the young/valvular heart disease group had the best baseline HRQoL and the greatest physical limitation scores.
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