title: Relationship of quality of life scores with baseline characteristics and outcomes in the African-American heart failure trial.
abstract: BACKGROUND
  To characterize the quality of life (QOL) in the African-American Heart Failure Trial (A-HeFT) for factors associated with baseline score, relation of score to prognosis, and response to therapy with a fixed-dose combination of isosorbide dinitrate/hydralazine (FDC I/H). Limited data exist on QOL scores in African-American heart failure patients or on the prognostic value of theses scores in any population. Finally, the effect of FDC I/H on QOL scores, particularly in A-HeFT, is not known.
  
  
  RESULTS
  A-HeFT randomized 1050 African-American patients with New York Heart Association (NYHA) Class III-IV heart failure and systolic dysfunction. QOL measurements using Minnesota Living with Heart Failure Questionnaire (MLHFQ) were done at baseline and 3-month intervals. At baseline, worse MLHFQ scores were associated with younger age, female sex, greater body mass index, nonischemic etiology, high heart rate and NYHA Class, low systolic blood pressure, and chronic obstructive pulmonary disease. Both baseline and change in MLHFQ score were associated with a higher risk for combined all-cause mortality or heart failure hospitalization (baseline P < .0001, change at 3 months P=.001, and at 6 months P=.0008), but not mortality. Treatment with FDC I/H significantly improved MLHFQ score compared with placebo.
  
  
  CONCLUSIONS
  In A-HeFT, baseline QOL (MLHFQ) scores and change in score were predictive of combined HF morbidity and mortality outcomes. FDC I/H consistently improved QOL scores in A-HeFT compared with placebo.
authors: Veterans Affairs Medical Center, Washington, DC 20422-0001, USA. Peter.Carson@med.va.gov
authors: Peter
authors: P
authors: Carson
authors: S William
authors: SW
authors: Tam
authors: Jalal K
authors: JK
authors: Ghali
authors: W Tad
authors: WT
authors: Archambault
authors: Anne
authors: A
authors: Taylor
authors: Jay N
authors: JN
authors: Cohn
authors: Virginia M
authors: VM
authors: Braman
authors: Manuel
authors: M
authors: Worcel
authors: Inder S
authors: IS
authors: Anand
mesh_terms: D000328:Adult; D001741:Black or African American / Q000208:ethnology* / Q000523:psychology*; D000368:Aged; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000208:ethnology* / Q000523:psychology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012107:Research Design / Q000639:trends; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult