Cooper Trond J, Anker Stefan D, Comin-Colet Josep, Filippatos Gerasimos, Lainscak Mitja, Lüscher Thomas F, Mori Claudio, Johnson Patrick, Ponikowski Piotr, Dickstein Kenneth
Department of Cardiology, Stavanger University Hospital, Stavanger, Norway.
Innovative Clinical Trials, Department of Cardiology and Pneumology, University Medical Center Göttingen, Göttingen, Germany.
Am J Cardiol. 2016 May 1;117(9):1482-7. doi: 10.1016/j.amjcard.2016.02.018. Epub 2016 Feb 17.
Clinical status in heart failure is conventionally assessed by the physician's evaluation, patients' own perception of their symptoms, quality of life (QoL) tools, and a measure of functional capacity. These aspects can be measured with tools such as the New York Heart Association functional class, QoL tools such as the EuropeanQoL-5 dimension, the Kansas City Cardiomyopathy Questionnaire, patient global assessment (PGA), and by 6-minute walk test (6MWT), respectively. The ferric carboxymaltose in patients with heart failure and iron deficiency (FAIR-HF) trial demonstrated that treatment with intravenous ferric carboxymaltose in iron-deficient patients with symptomatic heart failure with reduced left ventricular function, significantly improved all 5 outcome measures. This analysis assessed the correlations between the longitudinal changes in the measures of clinical status, as measured by QoL tools and the changes in the measures of functional capacity as measured by the 6MWT. This analysis used the database from the FAIR-HF trial, which randomized 459 patients with chronic heart failure (reduced left ventricular ejection fraction) and iron deficiency, with or without anemia to ferrous carboxymaltose or placebo. The degree of correlation between QoL tools and the 6MWT was assessed at 4, 12, and 24 weeks. The data demonstrate highly significant correlations between QoL and functional capacity, as measured by the 6MWT, at all time points (p <0.001). Changes in PGA, Kansas City Cardiomyopathy Questionnaire, and EuroQoL-5D correlated increasingly over time with changes in 6MWT performance. Interestingly, the strongest correlation at 24 weeks is for the PGA, which is a simple numerical scale (r = -0.57, p <0.001). This analysis provides evidence that QoL assessment show a significant correlation with functional capacity, as measured by the 6MWT. The strength of these correlations increased over time.
传统上，心力衰竭的临床状况是通过医生的评估、患者对自身症状的感知、生活质量（QoL）工具以及功能能力的测量来评估的。这些方面可以分别用纽约心脏协会功能分级等工具、欧洲五维健康量表等QoL工具、堪萨斯城心肌病问卷、患者整体评估（PGA）以及6分钟步行试验（6MWT）来测量。心力衰竭合并缺铁患者使用羧麦芽糖铁（FAIR-HF）试验表明，在左心室功能降低的缺铁性症状性心力衰竭患者中，静脉注射羧麦芽糖铁治疗显著改善了所有5项结局指标。该分析评估了通过QoL工具测量的临床状况指标的纵向变化与通过6MWT测量的功能能力指标变化之间的相关性。该分析使用了FAIR-HF试验的数据库，该试验将459例慢性心力衰竭（左心室射血分数降低）且缺铁的患者（有无贫血）随机分为羧麦芽糖铁组或安慰剂组。在4周、12周和24周时评估QoL工具与6MWT之间的相关性程度。数据表明，在所有时间点，通过6MWT测量的QoL与功能能力之间存在高度显著的相关性（p<0.001）。PGA、堪萨斯城心肌病问卷和欧洲五维健康量表的变化与6MWT表现的变化随时间的相关性越来越高。有趣的是，24周时相关性最强的是PGA，它是一个简单的数字量表（r = -0.57，p<0.001）。该分析提供了证据，表明QoL评估与通过6MWT测量的功能能力之间存在显著相关性。这些相关性的强度随时间增加。
