Abstract
PurposeTo determine the impact of non-cardiovascular comorbidities on the health-related quality of life (HRQoL) of patients with chronic heart failure (CHF).MethodsA scoping review of the scientific literature published between 2009 and 2019 was carried out. Observational studies which assessed the HRQoL of patients with CHF using validated questionnaires and its association with non-cardiovascular comorbidities were included.ResultsThe search identified 1904 studies, of which 21 fulfilled the inclusion criteria to be included for analysis. HRQoL was measured through specific, generic, or both types of questionnaires in 72.2%, 16.7%, and 11.1% of the studies, respectively. The most common comorbidities studied were diabetes mellitus (12 studies), mental and behavioral disorders (8 studies), anemia and/or iron deficiency (7 studies), and respiratory diseases (6 studies). Across studies, 93 possible associations between non-cardiovascular comorbidities and HRQoL were tested, of which 21.5% regarded anemia or iron deficiency, 20.4% mental and behavioral disorders, 20.4% diabetes mellitus, and 14.0% respiratory diseases. Despite the large heterogeneity across studies, all 21 showed that the presence of a non-cardiovascular comorbidity had a negative impact on the HRQoL of patients with CHF. A statistically significant impact on worse HRQoL was found in 84.2% of associations between mental and behavioral disorders and HRQoL (patients with depression had up to 200% worse HRQoL than patients without depression); 73.7% of associations between diabetes mellitus and HRQoL (patients with diabetes mellitus had up to 21.8% worse HRQoL than patients without diabetes mellitus); 75% of associations between anemia and/or iron deficiency and HRQoL (patients with anemia and/or iron deficiency had up to 25.6% worse HRQoL than between patients without anemia and/or iron deficiency); and 61.5% of associations between respiratory diseases and HRQoL (patients with a respiratory disease had up to 21.3% worse HRQoL than patients without a respiratory disease).ConclusionThe comprehensive management of patients with CHF should include the management of comorbidities which have been associated with a worse HRQoL, with special emphasis on anemia and iron deficiency, mental and behavioral disorders, diabetes mellitus, and respiratory diseases. An adequate control of these comorbidities may have a positive impact on the HRQoL of patients.
Highlights
Chronic heart failure (CHF) is a disease caused by structural or functional cardiac abnormalities that result in reduced cardiac output and/or increasedComín‐Colet et al Health Qual Life Outcomes (2020) 18:329 cardiac pressure at rest or stress [1, 2]
The bibliographic search identified 1,904 records (666 in PubMedTM/MEDLINETM, 980 in EmbaseTM and 258 in the Cochrane Database of Systematic Reviews), which were reduced to 1,501 articles after eliminating duplicates
Characteristics of the participants The patient samples included in the selected studies ranged between 96 and 3,499 patients and, when indicated, we found that they were mostly composed of nonhospitalized patients (11/15) [15, 17, 18, 27, 30, 31, 33, 34, 36–38], with a greater proportion of men than women (20/21) [8, 14–18, 26–34, 36–40], aged over 60 (16/20) [8, 14, 16–18, 26, 29–34, 36–38, 40], with New York Heart Association I-II functional level (10/18) [8, 14, 15, 18, 27, 30, 34, 36, 38, 39], and reduced left ventricular ejection fraction (LVEF) (12/16) [8, 14, 17, 27–29, 32–34, 37, 38, 40] (Additional file 2: Tables 1 and 2)
Summary
Chronic heart failure (CHF) is a disease caused by structural or functional cardiac abnormalities that result in reduced cardiac output and/or increasedComín‐Colet et al Health Qual Life Outcomes (2020) 18:329 cardiac pressure at rest or stress [1, 2]. Chronic heart failure (CHF) is a disease caused by structural or functional cardiac abnormalities that result in reduced cardiac output and/or increased. The prevalence of CHF is estimated at 1–3% of the adult population, exceeding 10% in people over 70, and 30% in people over 85 [3]. Due to the aging of the population, the prevalence of CHF is estimated to increase by 46% in 2030 compared to 2012 in the United States [4]. Patients with CHF often have multiple comorbidities, both cardiovascular and non-cardiovascular, which accelerate disease progression, to a greater or lesser extent, and worsen the response to treatment [5, 6]. It is known that patients with non-cardiovascular comorbidities present a higher risk of mortality and increased length of hospitalization compared to patients with CHF without comorbidities or those with only cardiovascular comorbidities [5, 7, 8, 11, 12]
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