使用明尼苏达心力衰竭生活问卷评估恰加斯心肌病患者与健康相关的生活质量：一项验证研究。
Assessment of health-related quality of life in patients with Chagas cardiomyopathy using Minnesota living with heart failure questionnaire: A validation study.
作者信息
Trindade Ana Flávia Vieira, Silva Whesley Tanor, Lima Vanessa Pereira, Mendonça Vanessa Amaral, Lacerda Ana Cristina Rodrigues, Ávila Matheus Ribeiro, de Oliveira Lucas Fróis Fernandes, de Almeida Igor Lucas Geraldo Izalino, Silva Keity Lamary Souza, de Oliveira Luciano Fonseca Lemos, Carvalho Liliany Mara Silva, da Cruz Ferreira Paulo Henrique, de Faria Sanny Cristina Castro, Mediano Mauro Felippe Felix, Figueiredo Pedro Henrique Scheidt, Costa Henrique Silveira
机构信息
Physiotherapy Department, Healthy and Biological Sciences Faculty, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brasil.
Postgraduate course of Reabilitação e Desempenho Funcional, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, MG, Brasil.
出版信息
Trop Med Int Health. 2024 Jan;29(1):6-12. doi: 10.1111/tmi.13944. Epub 2023 Nov 12.
OBJECTIVE
Chagas cardiomyopathy (ChC) is the most severe clinical form of Chagas disease and, in association with psychosocial factors, can compromise the health-related quality of life (HRQoL) of affected patients. To date, there is no specific instrument to assess the HRQoL of these patients, and the Minnesota Living with Heart Failure Questionnaire (MLwHFQ), specific for heart failure, is being used both in research and current clinical practice. Therefore, we aimed to verify the validity of the MLwHFQ in the assessment of HRQoL of patients with ChC.
METHODS
Fifty patients with ChC (50.6 ± 10.1 years, NYHA I-III) were evaluated. The MLwHFQ, Short-Form of Health Survey (SF-36), Beck Depression Inventory (BDI), and Human Activity Profile (HAP) were applied. All patients underwent echocardiography and Cardiopulmonary Exercise Testing (CPET).
RESULTS
The MLwHFQ score correlated with almost all SF-36 domains (with r-value ranging from -0.38 to -0.69), except pain (p = 0.118). The MLwHFQ score also correlated with the BDI score (r = 0.748; p < 0.001), HAP score (r = -0.558; p = 0.001), peak oxygen uptake (r = -0.352; p = 0.01), and left ventricular ejection fraction (r = -0.329; p = 0.021). There was no significant difference in the score found on the MLwHFQ among NYHA classes (p = 0.101), as well as between patients with systolic dysfunction (n = 30) and preserved cardiac function (n = 20) (p = 0.058). Similarly, there was no significant difference in the score found on the physical (p = 0.423) and mental (p = 0.858) components of SF-36 between patients with systolic dysfunction and preserved cardiac function (p = 0.271 and p = 0.609, respectively). There was also no difference in the mental component of SF-36 among NYHA classes (p = 0.673). However, the HRQoL using the physical component of SF-36 was worse in advanced NYHA classes (p = 0.014).
CONCLUSION
MLwHF correlated with most SF-36 HRQoL domains, depressive symptoms, physical activity, and systolic function and seems to be valid in assessing the HRQoL of ChC patients.
目的
恰加斯心肌病（ChC）是恰加斯病最严重的临床形式，与社会心理因素相关，会损害受影响患者的健康相关生活质量（HRQoL）。迄今为止，尚无评估这些患者HRQoL的特定工具，而专门用于心力衰竭的明尼苏达心力衰竭生活问卷（MLwHFQ）在研究和当前临床实践中均有使用。因此，我们旨在验证MLwHFQ在评估ChC患者HRQoL方面的有效性。
方法
对50例ChC患者（年龄50.6±10.1岁，纽约心脏协会心功能分级I - III级）进行评估。应用了MLwHFQ、健康调查简表（SF - 36）、贝克抑郁量表（BDI）和人类活动概况（HAP）。所有患者均接受了超声心动图检查和心肺运动试验（CPET）。
结果
MLwHFQ评分与几乎所有SF - 36领域相关（r值范围为 - 0.38至 - 0.69），疼痛领域除外（p = 0.118）。MLwHFQ评分还与BDI评分（r = 0.748；p < 0.001）、HAP评分（r = - 0.558；p = 0.001）、峰值摄氧量（r = - 0.352；p = 0.01）和左心室射血分数（r = - 0.329；p = 0.021）相关。纽约心脏协会心功能分级之间MLwHFQ评分无显著差异（p = 0.101），收缩功能障碍患者（n = 30）和心功能保留患者（n = 20）之间也无显著差异（p = 0.058）。同样，收缩功能障碍患者和心功能保留患者之间，SF - 36身体（p = 0.423）和心理（p = 0.858）成分评分也无显著差异（分别为p = 0.271和p = 0.609）。纽约心脏协会心功能分级之间SF - 36心理成分也无差异（p = 0.673）。然而，纽约心脏协会心功能分级晚期患者使用SF - 36身体成分评估的HRQoL较差（p = 0.014）。
结论
MLwHF与大多数SF - 36 HRQoL领域、抑郁症状、身体活动和收缩功能相关，似乎可有效评估ChC患者的HRQoL。
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