Paleckiene R, Zaliaduonyte D, Dambrauskiene V, Macijauskiene J
Department of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Nursing Management Service, Kaunas Hospital of the Lithuanian University of Health Sciences, Kaunas, Lithuania.
Front Cardiovasc Med. 2024 Apr 5;11:1358390. doi: 10.3389/fcvm.2024.1358390. eCollection 2024.
The well-being of individuals with chronic heart failure (HF) is significantly influenced by their health-related quality of life (HRQoL), which serves as a crucial measure indicating how HF affects their daily activities. Monitoring programs aimed at reducing the number of hospitalizations and improving functional conditions are currently being offered to patients with chronic HF.
To examine the long-term health-related quality of life changes in patients with heart failure enrolled in a follow-up program after hospitalization and to evaluate the factors associated with quality of life of patients with heart failure.
This prospective study was conducted between 2019 and 2020 at the Department of Cardiology of Lithuanian University of Health Sciences. Patients were divided into two groups: Group I consisted of 71 patients (60.2%) where the Minnesota Living with Heart Failure Questionnaire (MLHFQ) score decreased by more than 10 points at 4th visit if compared to the 1st one; and Group II consisted of 47 patients (39.8%) where the MLHFQ score remained unchanged or increased by less than 10 points at the 4th visit if compared to the 1st visit.
Statistically significant differences were observed between groups. In Group II, a history of myocardial infarction was more frequent ( = 0.038), and there was a significantly higher occurrence of significant coronary artery disease ( = 0.006). Laboratory parameters indicating liver function exhibited statistically significant deterioration among patients in Group II. Specifically, AST ( = 0.050), ALT ( = 0.010), and GGT ( = 0.031) levels significantly increased. Upon analyzing the echocardiographic data, a statistically significant difference was found between the groups in relation to the left ventricular ejection fraction (LVEF) ( = 0.043) and TAPSE ( = 0.031). An analysis of changes in dimensions related to QoL was conducted during the long-term follow-up program, which revealed statistically significant differences between groups in overall changes based on the MLHFQ ( < 0.001). This difference was also observed across all dimensions, including the emotional, physical, and social aspects ( < 0.001).
Patients who had a higher LVEF at baseline, as well as those with an etiology of ischemic heart disease (IHD), better liver function, and fewer manifestations of edema, demonstrated a statistically significant improvement in their quality of life throughout the course of the patient monitoring program.
慢性心力衰竭（HF）患者的健康状况受到其健康相关生活质量（HRQoL）的显著影响，HRQoL是衡量HF如何影响其日常活动的关键指标。目前正在为慢性HF患者提供旨在减少住院次数和改善功能状况的监测项目。
研究住院后参加随访项目的心力衰竭患者长期健康相关生活质量的变化，并评估与心力衰竭患者生活质量相关的因素。
这项前瞻性研究于2019年至2020年在立陶宛卫生科学大学心脏病学系进行。患者分为两组：第一组由71名患者（60.2%）组成，与第一次就诊相比，第四次就诊时明尼苏达心力衰竭生活问卷（MLHFQ）得分下降超过10分；第二组由47名患者（39.8%）组成，与第一次就诊相比，第四次就诊时MLHFQ得分保持不变或增加少于10分。
两组之间观察到统计学上的显著差异。在第二组中，心肌梗死病史更为常见（P = 0.038），严重冠状动脉疾病的发生率显著更高（P = 0.006）。表明肝功能的实验室参数在第二组患者中显示出统计学上的显著恶化。具体而言，谷草转氨酶（AST）（P = 0.050）、谷丙转氨酶（ALT）（P = 0.010）和γ-谷氨酰转肽酶（GGT）（P = 0.031）水平显著升高。分析超声心动图数据时，两组在左心室射血分数（LVEF）（P = 0.043）和三尖瓣环平面收缩期位移（TAPSE）（P = 0.031）方面存在统计学上的显著差异。在长期随访项目中对与生活质量相关维度的变化进行了分析，结果显示基于MLHFQ的总体变化在两组之间存在统计学上的显著差异（P < 0.001）。在包括情感、身体和社会方面的所有维度上也观察到了这种差异（P < 0.001）。
在整个患者监测项目过程中，基线左心室射血分数较高的患者，以及患有缺血性心脏病（IHD）、肝功能较好且水肿表现较少的患者，其生活质量有统计学上的显著改善。
