Khaidirman Sophia K, Hasan Harris, Andra Cut A, Lubis Hilfan Ap, Dangana Amos, Haykal T Bob
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.
Department of Medical Laboratory Services, University of Abuja Teaching Hospital, Gwagwalada, Nigeria.
Narra J. 2024 Aug;4(2):e707. doi: 10.52225/narra.v4i2.707. Epub 2024 Jun 19.
Heart failure is a complex clinical manifestation due to diastolic dysfunction and systolic dysfunction of the left ventricle (LV). Diastolic dysfunction of the LV plays an important role in worsening the quality of life (QoL) in heart failure patients. The aim of this study was to assess the relationship between the severity or grade of LV diastolic dysfunction and QoL in heart failure with reduced ejection fraction (HFrEF) patients. A retrospective cohort study was conducted at the Cardiac Center of H. Adam Malik Hospital, Medan, Indonesia, from January 2022 to December 2022. This study included inpatients and outpatients aged above 18 years who were diagnosed with HFrEF, identified by echocardiography with an ejection fraction of ≤40%. Echocardiography was performed to evaluate left ventricular diastolic dysfunction, and QoL was assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ) 6-12 months after the severity of LV diastolic dysfunction was confirmed. The MLHFQ was classified into good and poor QoL. The severity of LV diastolic function was measured using the E/A ratio, mean E/e' ratio, tricuspid regurgitation velocity (TR Vmax), and left atrial volume index (LAVI), and was classified into grades I, II, and III. The relationships between the severity of diastolic dysfunction and other factors with QoL were measured using Chi-squared, Fisher's exact test, or Mann-Whitney test, as appropriate. A total of 96 patients were included in the study, of which 56 (58.3%) patients had grade I, 12 (12.5%) had grade II, and 28 (29.2%) patients had grade III of LV diastolic dysfunction. There were 77 (80.2%) and 19 (19.8%) patients with good and poor QoL, respectively. This study revealed a significant relationship between the severity of LV diastolic dysfunction and QoL in HFrEF patients with =0.040. In conclusion, the degree of LV diastolic dysfunction is related to the QoL of HFrEF patients and therefore better comprehensive management strategies should be considered in HFrEF cases to address the impact of LV diastolic dysfunction on QoL.
心力衰竭是一种由于左心室舒张功能障碍和收缩功能障碍引起的复杂临床表现。左心室舒张功能障碍在恶化心力衰竭患者的生活质量（QoL）方面起着重要作用。本研究的目的是评估射血分数降低的心力衰竭（HFrEF）患者左心室舒张功能障碍的严重程度或分级与生活质量之间的关系。2022年1月至2022年12月，在印度尼西亚棉兰市H. Adam Malik医院心脏中心进行了一项回顾性队列研究。本研究纳入了年龄在18岁以上、经超声心动图诊断为HFrEF（射血分数≤40%）的住院患者和门诊患者。进行超声心动图检查以评估左心室舒张功能障碍，并在确认左心室舒张功能障碍严重程度6 - 12个月后，使用明尼苏达心力衰竭生活问卷（MLHFQ）评估生活质量。MLHFQ分为生活质量良好和生活质量较差两类。使用E/A比值、平均E/e'比值、三尖瓣反流速度（TR Vmax）和左心房容积指数（LAVI）测量左心室舒张功能的严重程度，并分为I级、II级和III级。根据情况，使用卡方检验、Fisher精确检验或曼 - 惠特尼检验测量舒张功能障碍严重程度和其他因素与生活质量之间的关系。本研究共纳入96例患者，其中56例（58.3%）患者为左心室舒张功能障碍I级，12例（12.5%）为II级，28例（29.2%）患者为III级。生活质量良好和较差的患者分别有77例（80.2%）和19例（19.8%）。本研究揭示了左心室舒张功能障碍严重程度与HFrEF患者生活质量之间存在显著关系，P = 0.040。总之，左心室舒张功能障碍的程度与HFrEF患者的生活质量相关，因此在HFrEF病例中应考虑更好的综合管理策略，以应对左心室舒张功能障碍对生活质量的影响。
