1. Health-related quality of life in acute heart failure: association between patient-reported symptoms and markers of congestion.
- Author
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Lee MMY, Campbell RT, Claggett BL, Lewis EF, Docherty KF, Lindner M, Liu J, Solomon SD, McMurray JJV, and Platz E
- Subjects
- Male, Humans, Aged, Female, Stroke Volume, Prospective Studies, Quality of Life, Ventricular Function, Left, Dyspnea diagnosis, Dyspnea etiology, Patient Reported Outcome Measures, Heart Failure complications, Heart Failure diagnosis, Pulmonary Edema diagnostic imaging, Pulmonary Edema etiology
- Abstract
Aims: The aim of this study was to examine the association between patient-reported symptoms and the extent of pulmonary congestion in acute heart failure (AHF)., Methods and Results: In this prospective, observational study, patient-reported symptoms were assessed at baseline using the Kansas City Cardiomyopathy Questionnaire total symptom score (KCCQ-TSS) (range 0-100; 0 worst) in patients hospitalized for AHF. In a subset, patient-reported dyspnoea at rest and on exertion was examined (range 0-10; 10 worst) at baseline. In addition, 4-zone lung ultrasound (LUS) was performed at baseline at the time of echocardiography. B-lines were quantified offline, blinded to clinical findings, by a core laboratory. Chest X-ray (CXR) and physical examination findings were collected from the medical records. Among 322 patients (mean age 72, 60% men, mean left ventricular ejection fraction 39%) with AHF, the median KCCQ-TSS score was 33 (interquartile range 18-48). Worse KCCQ-TSS was associated with worse New York Heart Association class, dyspnoea at rest and on exertion, and peripheral oedema (p trend <0.001 for all). However, KCCQ-TSS was not associated with the extent of pulmonary congestion, as assessed by the number of B-lines on LUS, or findings on CXR, or physical examination (p trend >0.25 for all). Similarly, KCCQ-TSS was not significantly associated with echocardiographic markers of left ventricular filling pressure, pulmonary pressure or with N-terminal pro-B-type natriuretic peptide level., Conclusions: Among patients hospitalized for AHF, at baseline, KCCQ-TSS was not associated with pulmonary congestion assessed by LUS, CXR, or physical examination. These findings suggest that the profound reduction in KCCQ-TSS in patients with AHF may not be solely explained by pulmonary congestion., (© 2022 European Society of Cardiology.)
- Published
- 2023
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