Gundersen Guri H, Norekvål Tone M, Graven Torbjørn, Haug Hilde H, Skjetne Kyrre, Kleinau Jens O, Gustad Lise T, Dalen Håvard
Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.
Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
BMJ Open. 2017 Mar 20;7(3):e013734. doi: 10.1136/bmjopen-2016-013734.
We aimed to study whether patient-reported outcomes, measured by quality of life (QoL) and functional class, are sensitive to pleural effusion (PLE) in patients with heart failure (HF), and to study changes in QoL and functional class during follow-up of PLE.
A cohort of 62 patients from an outpatient HF clinic was included. The amount of PLE was quantified using a pocket-sized ultrasound imaging device. Self-reports of QoL and functional class were collected using the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and the New York Heart Association (NYHA) functional classification.
At baseline, 26 (42%) patients had PLE of which 19 (31%) patients had moderate to severe amounts of PLE. Patients with no to mild PLE had a lower MLHFQ score (mean 42, SD 21) compared with patients with a moderate to severe amount of PLE (mean 55, SD 24), p=0.03. For 28 patients (45%) with follow-up data, we observed a linear improvement of the MLHFQ-score (3.2, 95% CI 1.2 to 5.1) with each centimetre reduction of PLE. Correspondingly, patient-reported NYHA-class followed the same pattern as the MLHFQ-score.
Our study indicates that patient-reported outcome measures as MLHFQ may be sensitive tools to identify patients with HF at highest risk of symptomatic PLE and that treatment targeting reduction of PLE during follow-up is essential to improvement of QoL and functional capacity of outpatients with HF.
NCT01794715; Results.
我们旨在研究以生活质量（QoL）和功能分级衡量的患者报告结局对心力衰竭（HF）患者胸腔积液（PLE）是否敏感，并研究PLE随访期间QoL和功能分级的变化。
纳入了来自门诊HF诊所的62例患者队列。使用袖珍超声成像设备对PLE量进行量化。使用明尼苏达心力衰竭生活问卷（MLHFQ）和纽约心脏协会（NYHA）功能分级收集QoL和功能分级的自我报告。
在基线时，26例（42%）患者有PLE，其中19例（31%）患者有中度至重度PLE。与中度至重度PLE患者（平均55，标准差24）相比，无至轻度PLE患者的MLHFQ评分较低（平均42，标准差21），p=0.03。对于28例（45%）有随访数据的患者，我们观察到随着PLE每减少1厘米，MLHFQ评分呈线性改善（3.2，95%置信区间1.2至5.1）。相应地，患者报告的NYHA分级与MLHFQ评分遵循相同模式。
我们的研究表明，作为MLHFQ的患者报告结局测量指标可能是识别有症状PLE最高风险HF患者的敏感工具，并且在随访期间以减少PLE为目标的治疗对于改善HF门诊患者的QoL和功能能力至关重要。
NCT01794715；结果。
