Characterization of health-related quality of life in heart failure patients with preserved versus low ejection fraction in CHARM.
BACKGROUND
Limited comparative studies assessing the health-related quality of life (HRQL) in heart failure (HF) patients with preserved vs. low ejection fraction (LVEF) have been disparate.


OBJECTIVE
The aims of this study were a) to characterize HRQL in a large population of HF patients with preserved and low LVEF and b) to determine the factors associated with worse HRQL.


METHODS
Patients with symptomatic HF (NYHA Class II-IV) enrolled in the Candesartan in Heart Failure: Assessment of Reduction in Mortality and Morbidity (CHARM) HRQL study completed the Minnesota Living with Heart Failure questionnaire at randomization. Patients were stratified into 2 HF cohorts: preserved LVEF (>40%) and low LVEF (<or=40%).


RESULTS
In 2709 of the eligible 2744 (98.6%) patients, the summary scores ranged from 0 to 105 (mean 40.9). There were no differences in overall responses of HF patients with preserved vs. low LVEF (41.1 vs. 40.8). Independent factors associated with worse HRQL in both populations included female gender, younger age, higher body mass index, lower systolic blood pressure, greater symptom burden, and worse functional status.


CONCLUSIONS
In symptomatic HF patients, HRQL is equally impaired in both preserved and low LVEF populations. Targeting improvement in symptoms and HRQL is an important treatment objective in all HF patients.
Lewis
Eldrin F
EF
Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. eflewis@partners.org
Lamas
Gervasio A
GA
O'Meara
Eileen
E
Granger
Christopher B
CB
Dunlap
Mark E
ME
McKelvie
Robert S
RS
Probstfield
Jeffrey L
JL
Young
James B
JB
Michelson
Eric L
EL
Halling
Katarina
K
Carlsson
Jonas
J
Olofsson
Bertil
B
McMurray
John J V
JJ
Yusuf
Salim
S
Swedberg
Karl
K
Pfeffer
Marc A
MA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D001562:Benzimidazoles / Q000627:therapeutic use; D001713:Biphenyl Compounds; D001794:Blood Pressure; D015897:Comorbidity; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D013318:Stroke Volume / Q000502:physiology*; D013777:Tetrazoles / Q000627:therapeutic use
D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D010919:Placebos; D013777:Tetrazoles; C081643:candesartan