比较评估射血分数保留的心力衰竭患者健康相关生活质量的指标。
Comparing Measures to Assess Health-Related Quality of Life in Heart Failure With Preserved Ejection Fraction.
机构信息
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.
Duke Clinical Research Institute, Durham, North Carolina.
出版信息
JACC Heart Fail. 2018 Jul;6(7):552-560. doi: 10.1016/j.jchf.2018.02.006. Epub 2018 Jun 6.
OBJECTIVES
This study sought to compare the performance of 2 health-related quality of life (HRQOL) questionnaires in patients with heart failure with preserved ejection fraction (HFpEF).
BACKGROUND
The ability to accurately assess HRQOL over time is important in the care of patients with heart failure. The validity and reliability of HRQOL tools including the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and the Kansas City Cardiomyopathy Questionnaire (KCCQ) has not been fully determined or compared in patients with HFpEF.
METHODS
Among patients with stable chronic HFpEF enrolled in the NEAT (Nitrate Effect on Activity Tolerance in Heart Failure) trial (n = 110), the study evaluated and compared reliability, validity, and responsiveness to change of the MLHFQ and KCCQ at baseline, 6 weeks, and 12 weeks.
RESULTS
Internal consistency was good and comparable for MLHFQ and KCCQ domains measuring similar aspects of HRQOL at baseline including the MLHFQ physical (Cronbach's α = 0.93) compared with the KCCQ clinical summary (α = 0.91), and the MLHFQ emotional (α = 0.92) compared with the KCCQ quality of life (α = 0.87). Correlations with New York Heart Association functional class (Spearman rho; r= -0.37 vs. 0.30) and 6-min walk test (6MWT) (r = 0.38 vs. -0.23) at baseline were slightly stronger for the KCCQ overall summary score than for the MLHFQ total score. The MLHFQ was more responsive to change in 6MWT based on responsiveness statistics.
CONCLUSIONS
These data suggest that both the MLHFQ and KCCQ are reliable and valid tools to assess HRQOL in HFpEF. The KCCQ was more strongly correlated with baseline functional status parameters, while the MLHFQ was more responsive to improvement in 6MWT.
目的
本研究旨在比较 2 种与健康相关的生活质量（HRQOL）问卷在射血分数保留型心力衰竭（HFpEF）患者中的表现。
背景
能够准确评估心力衰竭患者随时间推移的 HRQOL 非常重要。在 HFpEF 患者中，尚未充分确定或比较包括明尼苏达州心力衰竭生活质量问卷（MLHFQ）和堪萨斯城心肌病问卷（KCCQ）在内的 HRQOL 工具的有效性和可靠性。
方法
在稳定的慢性 HFpEF 患者中进行的 NEAT（硝酸盐对心力衰竭活动耐量的影响）试验（n=110）中，本研究评估并比较了 MLHFQ 和 KCCQ 在基线、6 周和 12 周时的可靠性、有效性和对变化的反应性。
结果
MLHFQ 和 KCCQ 各领域的内部一致性良好，在基线时测量 HRQOL 的相似方面具有可比性，包括 MLHFQ 躯体领域（Cronbach's α=0.93）与 KCCQ 临床综合评分（α=0.91）相似，以及 MLHFQ 情绪领域（α=0.92）与 KCCQ 生活质量评分（α=0.87）相似。与纽约心脏协会功能分级（Spearman rho；r=-0.37 与 0.30）和 6 分钟步行试验（6MWT）（r=-0.38 与-0.23）的相关性在基线时，KCCQ 总分略强于 MLHFQ 总分。根据反应性统计数据，MLHFQ 对 6MWT 的变化更敏感。
结论
这些数据表明，MLHFQ 和 KCCQ 都是评估 HFpEF 患者 HRQOL 的可靠且有效的工具。KCCQ 与基线功能状态参数的相关性更强，而 MLHFQ 对 6MWT 的改善更敏感。
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