Key result
Low quality of life linked to ~120% greater mortality risk in HFpEF patients.
Why the study?
Improving quality of life is a key therapeutic goal in HFpEF, motivating this study to identify determinant factors of impaired quality of life and clarify its association with prognosis.
What are the determinants of impaired quality of life and its association with mortality in patients with acute decompensated HFpEF?
Observational (n=864)
Yes
What are the determinants of impaired quality of life and its association with mortality in patients with acute decompensated HFpEF?
Hazard Ratio: 2.2 (95% CI 1.4–3.45)
p-value: p=0.001
In patients with HFpEF, non-cardiac factors such as frailty and malnutrition drive impaired quality of life, which is independently associated with increased mortality.
Identifying social/comorbidity factors may inform holistic HFpEF care; leaves open causal QOL-prognosis links requiring prospective confirmation.
Background Improvement of quality of life (QOL) is one of the most important therapeutic goals for patients with heart failure with preserved ejection fraction (HFpEF). It is, therefore, clinically relevant to comprehensively identify aggravating factors among cardiac factors, non-cardiac comorbidities, and social factors. The aim of this study was to elucidate determinant factors of impaired QOL and clarify the association between QOL and prognosis in patients with HFpEF. Methods and results Patient data were extracted from The Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with Preserved Ejection Fraction (PURSUIT HFpEF) study. EuroQol 5 dimensions 5-level (EQ-5D-5L) data were obtained at discharge to evaluate patients' health-related QOL. A total of 864 patients were enrolled in this study. Multivariable logistic regression analysis revealed that only non-cardiac factors such as age, female sex, frailty, malnutrition and inflammation were significantly associated with low EQ-5D-5L score, whereas cardiac factors showed no significant association after multivariable adjustment. A total of 206 patients died over a mean follow-up period of 2.0±1.2 years. Kaplan–Meier survival curve analysis demonstrated a significant increase in risk of mortality stratified by tertiles of EQ-5D-5L score (p<0.0001). Cox multivariable analysis revealed that patients with low EQ-5D-5L score had a significantly greater risk of mortality than those with high EQ-5D-5L score (adjusted hazard ratio: 2.20 (1.40–3.45), p=0.001). Conclusion Among patients with HFpEF, non-cardiac factors such as age, female sex, frailty, malnutrition and inflammation are significantly associated with impaired QOL. The QOL score itself also offers useful prognostic information in patients with HFpEF. Funding Acknowledgement Type of funding sources: None.
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Seo et al. (2022) conducted an observational in Heart failure with preserved ejection fraction (HFpEF) (n=864). Low EQ-5D-5L score (impaired quality of life) vs. High EQ-5D-5L score was evaluated on Mortality (HR 2.20, 95% CI 1.40-3.45, p=0.001). Low quality of life (EQ-5D-5L score) was associated with a significantly greater risk of mortality compared to high quality of life in patients with HFpEF (adjusted HR 2.20; 95% CI 1.40-3.45; p=0.001).
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