Disability in heart failure: Contributions of clinical, functional, and contextual factors

Background The clinical condition of people with heart failure (HF) involves challenges that go beyond structural and functional changes in the heart, negatively impacting the quality of life and functioning. The degree of cardiac dysfunction cannot explain disability. Objective To investigate the clinical and functional factors associated with disability in the population with HF. Methods A cross-sectional, quantitative study was conducted in individuals with HF referred for cardiopulmonary exercise testing (CPET). Disability, sleep quality, and functional capacity were assessed by estimating oxygen consumption in metabolic equivalent (MET) using the following instruments, respectively: World Health Disability Assessment Schedule 2.0 (WHODAS 2.0), Pittsburgh Sleep Quality Index (PSQI), and Duke Activity Status Index (DASI). Peak oxygen consumption (VO 2 peak) from CPET was accessed from the medical report. Results The sample consisted of 74 participants, with a mean age of 56 ± 12 years and BMI of 28.0 ± 4.3 kg/m 2 . Individuals with NYHA ≥ II had greater disability. Each MET estimated by DASI was associated with lower disability levels across several WHODAS 2.0 domains. Dyslipidemia was associated with compromised cognition by 168 %. The left ventricular EF was associated with lower disability in the participation domain and with lower WHODAS 2.0 total scores. Poor sleep quality was associated with 236 % impairment in the cognition domain. Conclusions Disability in the HF population is significantly associated with worse functional class (NYHA ≥ II), dyslipidemia, and poor sleep quality.