Abstract 294: Association Between Exercise Frequency, Performance, and Health-Related Quality of Life in Heart Failure Patients

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Background: Heart failure (HF) is one of the leading causes of morbidity and mortality in the United States. Exercise intolerance and impaired quality of life (QOL) are common limitations. Cardiopulmonary exercise test (CPX) is used for risk stratification and diagnosis of ischemia in HF patients. In HF patients interested in rehabilitation protocols, higher exercise capacity has been linked to better QOL. The primary objective is to determine the association between QOL and exercise parameters in an unselected HF population. Methods: English-speaking HF patients scheduled for routine CPX were approached prospectively. Each consenting person completed 2 page survey on home environment, exercise routine, and QOL. Disease-specific QOL was measured using the Minnesota Living with Heart Failure Questionnaire (MLHF), a 21-item instrument that assesses perceptions of QOL related to their HF (scored 0 to 105 with lower score representing better QOL). Generic QOL was measured using a one-item visual analog scale (VAS), scored 0 to 100 with higher score representing better QOL. Patients were stratified by age, disability, exercise routine, HRR > 18 at 1minute, working status, emotional support, gender, live alone, and peak RER>1. Results of CPX were measured [e.g., heart rate recovery in 1 minute (HRR), peak oxygen uptake (peakVO2), respiratory exchange ratio (RER)]. Data was analyzed with Chi-square, t-test, and ANOVA using STATA. Results: We enrolled 167 patients (Mean age 54 + 11, Female 26%, peakVO2 15.7±6, peak RER 1.2±.12). The MLHF score was 44 + 28 and mean VAS score was 61.9±22. QOL is worse among patients who are younger (P=0.0042), non-working (51.3 VS. 34.1, P-0.001), and disabled (54.7 VS. 38.3). There is no association between QOL and exercise frequency, gender, emotional support, or living alone. Patients with HRR > 18 had better MLHF scores (38.0±28 vs. 52.9±26, p<0.001). PeakVO2 is moderately correlated to MLHF scores in all age categories; however, patients who lived alone did not have a strong correlation between peakVO2 and MLHF (r2=-0.256, p=0.21 vs. r2=-0.47, p<0.001). Conclusion: Routine exercise is not associated with better QOL in an unselected HF population. Performance on CPX was associated with QOL regardless of age. Although emotional support is not linked with QOL, those getting support from siblings tended to have a worse QOL than others. Strategies to improve QOL among HF patients should focus on factors beyond exercise.