Department of Cardiology, University Medical Center Groningen (UMCG), University of Groningen, RB Groningen, The Netherlands.
Eur J Heart Fail. 2013 Jan;15(1):94-102. doi: 10.1093/eurjhf/hfs148. Epub 2012 Sep 18.
To examine whether self-rated disease-specific and generic quality of life predicts long-term mortality, independent of brain natriuretic peptide (BNP) levels, and to explore factors related to low quality of life in a well-defined heart failure (HF) population.
A cohort of 661 patients (62% male; age 71 years; left ventricular ejection fraction 34%) was followed prospectively for 3 years. Quality of life questionnaires (Ladder of Life, RAND36, and Minnesota Living with Heart Failure Questionnaire) and BNP levels were assessed at discharge after a hospital admission for HF. Three-year mortality was 42%. After adjustment for demographic variables, clinical variables, and BNP levels, poor quality of life scores predicted higher mortality; per 10 units on the physical functioning [hazard ratio (HR) 1.08, 95% confidence interval (CI) 1.02-1.14] and general health (HR 1.08, 95% CI 1.01-1.16) dimensions of the RAND36. Patients with low scores on these dimensions were more likely to be in New York Heart Association class III-IV, diagnosed with co-morbidities, have suffered longer from HF, have lower estimated glomerular filtration rates, and have fewer beta-blocker prescriptions.
Quality of life was independently related to survival in a cohort of hospitalized patients with HF.
NCT 98675639.
探讨自评疾病特异性和一般性生活质量是否可独立于脑钠肽（BNP）水平预测长期死亡率，并探索在明确的心力衰竭（HF）人群中与生活质量低相关的因素。
前瞻性随访了 661 例患者（62%为男性；年龄 71 岁；左心室射血分数 34%）3 年。在因 HF 住院后出院时评估了生活质量问卷（生活梯级、RAND36 和明尼苏达心力衰竭生活质量问卷）和 BNP 水平。3 年死亡率为 42%。调整人口统计学变量、临床变量和 BNP 水平后，生活质量评分差预测死亡率更高；RAND36 身体功能[风险比（HR）1.08，95%置信区间（CI）1.02-1.14]和一般健康（HR 1.08，95% CI 1.01-1.16）维度每增加 10 个单位。这些维度得分低的患者更有可能处于纽约心脏协会（NYHA）III-IV 级，伴有合并症，HF 病程较长，估算肾小球滤过率较低，β受体阻滞剂处方较少。
在 HF 住院患者队列中，生活质量与生存率独立相关。
NCT 98675639。
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