Abstract 17341: Comparing the Kansas City Cardiomyopathy Questionnaire and New York Heart Association in Assessing Functional Capacity and Outcomes

Abstract

Background: The Kansas City Cardiomyopathy Questionnaire (KCCQ) has emerged as a patient-centered, heart failure-specific health status measure. This study examined the correlation between KCCQ and cardiopulmonary exercise testing (CPET) parameters and clinical outcomes, in comparison to the physician-derived New York Heart Association (NYHA) functional class. Methods and Results: We performed a single-centered, observational prospective analysis of 432 outpatients who presented to the Heart Failure Department, completed the KCCQ, and underwent CPET. Outcomes assessed included 30-day heart failure hospitalization and all-cause mortality. Among the KCCQ scores, the physical limitation domain had similar correlations as NYHA with peak oxygen consumption (r = 0.48 for both, p < 0.001) and ventilatory threshold (r = 0.42 versus r = 0.40, respectively, p < 0.001). The KCCQ overall score predicted 30-day hospitalization (OR 0.77, 95% CI 0.66 to 0.88, p < 0.001) and mortality (HR 0.91, 95% CI 0.88 to 0.95, p < 0.0001). NYHA could not differentially predict mortality between functional class II and III patients who comprised the majority of our cohort, although it did predict 30-day heart failure hospitalization in this group. Using model validation, NYHA was the best predictor of peak VO 2 (r 2 = 0.36), KCCQ total symptom score the best predictor of 30-day heart failure hospitalization (AUC = 0.724), and KCCQ physical limitation score the best predictor of mortality (AUC = 0.671). Conclusions: KCCQ and NYHA provide a reasonable assessment of functional capacity, the latter being more predictive. KCCQ is superior to NYHA in its ability to predict clinical outcomes. These findings support its routine use in clinical care, as well as its potential to serve as a measure in clinical trials.