Key result
LVEF category shows no association with physical or mental health-related quality of life.
Why the study?
Heart failure substantially affects health-related quality of life, but evidence across LVEF categories in Jordan remains limited.
Cross-Sectional (n=516)
Yes
p-value: p=0.111 (physical); 0.613 (mental)
Health-related quality of life in heart failure is more strongly driven by functional limitations, psychological distress, and self-care efficacy than by left ventricular ejection fraction category.
Functional and psychosocial factors may outweigh EF in driving HRQoL among HF patients; leaves open whether targeted interventions improve outcomes in prospective studies.
Background: Heart failure (HF) substantially affects health-related quality of life (HRQoL), but evidence across left ventricular ejection fraction (LVEF) categories in Jordan remains limited. Methods: This multicenter cross-sectional study included 516 adults with HF attending outpatient cardiac clinics in northern Jordan between May and November 2025. SF-36 Version 1.0 items were recoded to eight 0–100 domains, and unweighted SF-36 physical and mental four-domain composite scores were analyzed using expanded multivariable ordinary least-squares models with HC3 robust standard errors. A total of 476 participants had complete data for all model variables. Results: The mean SF-36 physical and mental four-domain composite scores were 48.80 (SD 21.14) and 51.88 (SD 20.57), respectively. Both scores differed across EF categories before adjustment (physical p < 0.001; mental p < 0.001), but the adjusted EF omnibus tests were not significant (physical p = 0.111; mental p = 0.613). Lower physical scores were associated with NYHA class II and III, physical inactivity, sleeping difficulty, retirement, and higher anxiety and depression scores, whereas self-care efficacy was positively associated with physical HRQoL. Lower mental scores were associated with NYHA class II and III, physical inactivity, and higher anxiety and depression scores, while self-care efficacy was positively associated with mental HRQoL. Conclusions: In this cross-sectional sample, functional limitation, anxiety and depressive symptoms, physical inactivity, and self-care efficacy were more consistently associated with HRQoL than EF category after adjustment. These findings support multidimensional assessment alongside cardiac measures.
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Alkouri et al. (2026) conducted a cross-sectional in Heart Failure (n=516). Ejection fraction category vs. HFpEF (≥50%) was evaluated on SF-36 physical and mental four-domain composite scores (p=0.111 (physical); 0.613 (mental)). After adjustment, ejection fraction category was not significantly associated with physical or mental health-related quality of life, whereas functional limitation, anxiety, depressive symptoms, physical inactivity, and self-care efficacy were.
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