Fonseca Ana Filipa, Lahoz Raquel, Proudfoot Clare, Corda Stefano, Loefroth Emil, Jackson James, Cotton Sarah, Studer Rachel
Novartis Pharma AG, Basel, Switzerland.
Adelphi Real World, Bollington, UK.
Patient Prefer Adherence. 2021 Jul 30;15:1693-1706. doi: 10.2147/PPA.S312200. eCollection 2021.
To characterize symptoms, clinical burden, and health-related quality of life (HRQoL) among women and men with heart failure (HF) with a left ventricular ejection fraction (LVEF) of ≤60% in Europe.
A real-world cross-sectional study was conducted in France, Germany, Italy, Spain, and United Kingdom from June to November 2019. Patient record forms were completed by 257 cardiologists and 158 general practitioners for consecutive patients with HF. The same patients were invited to complete a questionnaire comprising patient-reported outcomes: the Minnesota Living with Heart Failure Questionnaire (MLHFQ), five-level five-dimension EuroQol questionnaire (EQ-5D-5L), Visual Analogue Scale (VAS), and Work Productivity and Activity Impairment questionnaire.
The mean age of 804 patients (men, n=517; women, n=287) was 68.6 years (men, 67.8 years; women, 70.2 years; p=0.0022). The mean LVEF was 44.7% (men, 43.6%; women, 46.8%; p<0.0001). Patients reported dyspnoea when active (overall, 55.7%; men, 56.0%; women, 55.3%), fatigue/weakness/faintness (34.5%; men, 32.9%; women, 37.2%), and oedema (20.3%; men, 18.7%; women, 23.1%) as the most troublesome HF symptoms. Overall, 54.1% of patients reported low mood/depression (men, 50.8%; women, 60.1%). The overall MLHFQ mean score was higher (ie, poorer HRQoL) among women vs men (37.9 vs 34.6; p=0.0481). MLHFQ was consistently higher (ie, poorer HRQoL) for women vs men across the physical (18.6 vs 16.6; p=0.0041) and emotional (9.4 vs 7.9; p=0.0021) scoring domains. Mean EQ-5D utility (0.69 vs 0.75; p=0.0046) and VAS scores (55.4 vs 61.3; p<0.0001) were lower among women compared with men. Overall, 23.4% of patients were hospitalized owing to HF in the previous year (men, 22.7%; women, 24.6%). Patients reported 43.2% activity impairment due to HF (men, 41.6%; women, 46.4%; p=0.01).
HF causes a substantial burden on patients, with a greater burden among women vs men. This gender-related difference is consistent with other HF studies, warranting further research to understand the underlying reasons.
描述欧洲左心室射血分数（LVEF）≤60%的心力衰竭（HF）男性和女性患者的症状、临床负担及健康相关生活质量（HRQoL）。
2019年6月至11月在法国、德国、意大利、西班牙和英国进行了一项真实世界横断面研究。257名心脏病专家和158名全科医生为连续性HF患者填写患者记录表。邀请相同的患者完成一份包含患者报告结局的问卷：明尼苏达心力衰竭生活问卷（MLHFQ）、五级五维度欧洲生活质量问卷（EQ-5D-5L）、视觉模拟量表（VAS）以及工作效率和活动障碍问卷。
804例患者（男性n = 517；女性n = 287）的平均年龄为68.6岁（男性67.8岁；女性70.2岁；p = 0.0022）。平均LVEF为44.7%（男性43.6%；女性46.8%；p<0.0001）。患者报告活动时呼吸困难（总体55.7%；男性56.0%；女性55.3%）、疲劳/虚弱/头晕（34.5%；男性32.9%；女性37.2%）以及水肿（20.3%；男性18.7%；女性23.1%）是最困扰的HF症状。总体而言，54.1%的患者报告情绪低落/抑郁（男性50.8%；女性60.1%）。女性的总体MLHFQ平均得分高于男性（即HRQoL较差）（37.9对34.6；p = 0.0481）。在身体（18.6对16.6；p = 0.0041）和情感（9.4对7.9；p = 0.0021）评分领域，女性的MLHFQ得分始终高于男性（即HRQoL较差）。女性的平均EQ-5D效用值（0.69对0.75；p = 0.0046）和VAS得分（55.4对61.3；p<0.0001）低于男性。总体而言，23.4%的患者在上一年因HF住院（男性22.7%；女性24.6%）。患者报告因HF导致43.2%的活动受限（男性41.6%；女性46.4%；p = 0.01）。
HF给患者带来了沉重负担，女性的负担比男性更大。这种性别差异与其他HF研究一致，需要进一步研究以了解其潜在原因。
