Veterans Affairs Medical Center, Washington, DC 20422-0001, USA.
J Card Fail. 2009 Dec;15(10):835-42. doi: 10.1016/j.cardfail.2009.05.016.
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.
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.
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.
为了描述与基线评分相关的因素、与预后的关系以及固定剂量组合异山梨酯/肼屈嗪（FDC I/H）治疗的反应对非洲裔美国人心力衰竭试验（A-HeFT）的生活质量（QOL）进行特征描述。在非洲裔美国心力衰竭患者的 QOL 评分或任何人群中这些评分的预后价值方面，数据有限。最后，FDC I/H 对 QOL 评分的影响，特别是在 A-HeFT 中，尚不清楚。
A-HeFT 随机分配了 1050 名纽约心脏协会（NYHA）III-IV 级心力衰竭和收缩功能障碍的非洲裔美国患者。使用明尼苏达州心力衰竭生活质量问卷（MLHFQ）进行 QOL 测量，间隔 3 个月进行一次。基线时，更差的 MLHFQ 评分与年龄较小、女性、体重指数较大、非缺血性病因、心率较高和 NYHA 分级、较低的收缩压和慢性阻塞性肺疾病有关。基线和 MLHFQ 评分变化均与全因死亡率或心力衰竭住院的风险增加相关（基线 P<0.0001，3 个月时 P=0.001，6 个月时 P=0.0008），但与死亡率无关。与安慰剂相比，FDC I/H 治疗显著改善了 MLHFQ 评分。
在 A-HeFT 中，基线 QOL（MLHFQ）评分和评分变化可预测 HF 发病率和死亡率的综合结果。与安慰剂相比，FDC I/H 一致地改善了 A-HeFT 中的 QOL 评分。
