Patient reported outcome in HFpEF Sex-specific differences in quality of life and association with outcome

Abstract : Background - Heart failure with preserved ejection fraction (HFpEF) is associated with poor quality of life (QoL), or patient reported outcome (PRO). Despite female predominance in HFpEF, sex-specific differences in PROs remain poorly studied. We assessed PRO measures and their association with HF-severity and outcome in HFpEF by sex. Methods and results - In 378 patients with HFpEF from the KaRen study, EQ-5D-3L® and Minnesota Living with Heart Failure Questionnaire® (MLHFQ) were assessed. Characteristics and comorbidities were largely similar in women (n = 212, 57%) and men. Women expressed worse QoL in EQ-5D-3L®(EQ-VAS), independent of age and HF-severity, mean (SD), 57 (20) vs. 61 (19), p = 0.010. There was no difference in MLHFQ, 31 (21) vs. 29 (21), p = 0.269. Spearman's correlations with HF-severity (NYHA-class) were for MLHFQ in women r 0.37 vs. men 0.41, p for both <0.001, and for EQ-VAS r -0.28, p = 0.001 vs. -0.45, p < 0.001. Correlations with natriuretic peptides were for MLHFQ r 0.21, p = 0.003 in women vs. men 0.27, p < 0.001, and for EQ-VAS r -0.17 vs. -0.27, p both < 0.001. Associations between PRO and the composite of HF hospitalisation or all-cause death were present in men only, adjusted HR per 5 units increase in MLHFQ 1.06, 95% confidence interval (CI) 1.01-1.11, p = 0.02 and EQ-VAS, HR 0.93, 95% CI 0.88-0.98, p = 0.010. Conclusion - In HFpEF, women had worse general but similar disease specific QoL compared to men. QoL was more strongly associated with HF-severity in men, and associated with outcomes only in men. In women with HFpEF, QoL appears less determined by HF itself and potentially more by other unknown factors.
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Submitted on : Tuesday, July 10, 2018 - 9:19:23 AM
Last modification on : Wednesday, September 5, 2018 - 2:22:57 PM

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Ulrika Ljung Faxén, Camilla Hage, Erwan Donal, Jean-Claude Daubert, Cecilia Linde, et al.. Patient reported outcome in HFpEF Sex-specific differences in quality of life and association with outcome. International Journal of Cardiology, Elsevier, 2018, 267, pp.128-132. ⟨10.1016/j.ijcard.2018.04.102⟩. ⟨hal-01833889⟩

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