Minnesota Living With Heart Failure Questionnaire Research Articles

Association between isolated or combined malnutrition and sarcopenia and quality of life in heart failure outpatients: A cross-sectional study.

Heart failure (HF) is a chronic condition with symptoms linked to worse quality of life. Malnutrition and sarcopenia are conditions frequently found in patients with HF. This study aims to evaluate the association between isolated or combined malnutrition and sarcopenia and quality of life in outpatients with HF. This is a cross-sectional study with a sample of outpatients with HF aged ≥18 years. Malnutrition was assessed according to the criteria of the Global Leadership Initiative on Malnutrition, and sarcopenia was evaluated by the European Working Group on Sarcopenia in Older People. Quality of life was assessed using the Minnesota Living with HF questionnaire (MLHFQ). Clinical and sociodemographic data were collected. One hundred and fifty-one patients were included in this study, with a median (interquartile range) age of 58 (48-65) years, 58.9% were adults, and 68.9% were male. A total of 29.5% of the patients were malnourished, and 28.5% and 2.6% were identified with probable sarcopenia and sarcopenia, respectively. Of the total, 15.9% of patients were identified with both conditions. Sarcopenia was associated with higher odds of increase in the MLHFQ total score, indicating worse quality of life (odds ratio [OR] = 3.61; 95% CI, 1.65-7.89). The same was found in the presence of two conditions (OR 3.97; 95% CI, 1.32-11.54), whereas isolated malnutrition was not related to life quality (OR = 1.62; 95% CI, 0.73-3.60). The presence of malnutrition and sarcopenia simultaneously were associated with worse quality of life scores when compared with these isolated conditions.

A follow-up program in patients after hospitalization for heart failure: long-term health related quality of life and associated factors.

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 (p = 0.038), and there was a significantly higher occurrence of significant coronary artery disease (p = 0.006). Laboratory parameters indicating liver function exhibited statistically significant deterioration among patients in Group II. Specifically, AST (p = 0.050), ALT (p = 0.010), and GGT (p = 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) (p = 0.043) and TAPSE (p = 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 (p < 0.001). This difference was also observed across all dimensions, including the emotional, physical, and social aspects (p < 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.

Assessing the diversity and determinants of health-related quality of life measures in patients with acute heart failure.

Heart failure with reduced ejection fraction (HFrEF) significantly impacts health-related quality of life (HR-QoL). Existing HR-QoL questionnaires can show inconsistencies, potentially misrepresenting patient self-reports. This study examines the variation in HR-QoL measurement tools for HFrEF patients, identifying related determinants. We retrospectively analysed 134 hospitalized patients with acute decompensated HFrEF at a Taiwanese tertiary centre's Heart Failure Post-Acute-Care (HF-PAC) programme. Participants completed the EuroQol-5 dimension (EQ-5D) questionnaire, the EQ-5D visual analogue scale (VAS), and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Utility values were obtained from the EQ-5D questionnaire. Demographic features were depicted using descriptive statistics, while multivariate regression was used to ascertain relationships between HR-QoL measurements and determinants. Average scores for EQ-5D, MLHFQ, EQ-5D utility, and VAS were 6.1±1.6, 21.8±21.3, 81.7±27.0, and 59.5±14.6, respectively. Significant correlations were observed among the three tools. The New York Heart Association functional class showed a notable association with all tool scores. Other associations encompassed EQ-5D with coronary artery disease, mineralocorticoid receptor antagonists, and the 6min walk test; EQ-5D VAS with chronic kidney disease; and MLHFQ with age. This study illuminates the variance in HR-QoL measurement tools for Taiwanese HFrEF patients. Using a range of these tools is beneficial in unveiling diverse determinants and approaching comprehensive patient-centred care. However, for a more precise HR-QoL assessment in Taiwanese HFrEF patients, recalibrating the EQ-5D-derived utility scores might be necessary, emphasizing the importance of patient-specific considerations within the HF-PAC programme.

Effect of dapagliflozin on blood glucose control, cardiac function, and myocardial injury markers in patients with type 2 diabetes and heart failure

Purpose: To investigate the impact of dapagliflozin treatment on blood glucose control, cardiac function, and myocardial injury markers in patients with type 2 diabetes and heart failure. &#x0D; Methods: In a retrospective analysis of clinical data for 132 patients with type 2 diabetes and heart failure admitted to Beijing Tongren Hospital, China from January 2020 to June 2021, these patients were stratified into two groups (66 patients each). Control group received conventional pharmacotherapy and study group received additional treatment with dapagliflozin. Both treatment courses lasted for 6 months. The levels of blood glucose control, cardiac function, and myocardial injury markers before and after 6 months of treatment were compared between the two groups, as well as safety during treatment. &#x0D; Results: After 6 months of treatment, both groups exhibited significant reductions in fasting plasma glucose (FPG), 2-h postprandial glucose (2 h PG), glycated hemoglobin (HbA1c), N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac troponin I (cTnI), creatine kinase-MB isoenzyme activity (CK-MB), aspartate aminotransferase (AST) levels, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), and Minnesota Living with Heart Failure Questionnaire (MLHFQ) score, with study group showing a greater improvement (p &lt; 0.05). &#x0D; Conclusion: Dapagliflozin enhances blood glucose control and cardiac function, improving quality of life in patients with type 2 diabetes and heart failure. Furthermore, Dapagliflozin demonstrates a safe and well-tolerated profile. Future studies will require establishing the mechanism of dapagliflozin action in a larger and more diverse population.

Role of preexisting right ventricular remodeling in symptoms and prognosis after transcatheter tricuspid valve repair.

Severe tricuspid regurgitation (TR) is associated with chronic volume overload and right ventricular remodeling (RVR). Transcatheter tricuspid valve repair (TTVr) reduces TR and can improve quality of life (QoL), but the role of preprocedural RVR on TTVr outcomes remains unclear. To investigate the role of RVR on outcomes after TTVr for severe TR. Consecutive patients undergoing TTVr (61% edge-to-edge vs. 39% direct annuloplasty) for severe TR were retrospectively compared by preexisting RVR which was defined as dilation of RV mid-level diameter (> 35mm) according to guidelines. QoL was evaluated using NYHA class, Minnesota Living with Heart Failure Questionnaire (MLHFQ), 36-Item Short Form Health Survey (SF-36), and 6-min walking distance (6MWD) 1-month after TTVr. Mid-term mortality and heart failure (HF) hospitalization were assessed through 1year. RVR was present in 137 of 223 patients (61%). Symptoms and QoL improved equally in both groups: ≥ 1 NYHA class (57% vs. 65% of patients with vs. without RVR, respectively), 6MWD (36% vs. 34%), MLHFQ (81% vs. 69%), and SF-36 (68% vs. 65%) improvement. One-year mortality and HF hospitalization were significantly higher in patients with RVR (24% and 30%, respectively) than in patients without (8% and 13%, both p < 0.05). In multivariable analysis, RVR was independently associated with mortality (HR 2.3, 95%CI (1.0-5.0), p = 0.04) and the combined endpoint of mortality or rehospitalization (HR 2.0, 95%CI (1.1-3.8), p = 0.03). TTVr was associated with significant QoL improvement after 1month, irrespective of RVR. Despite increased mortality and rehospitalization for heart failure, TTVr in the presence of RVR still provides substantial symptomatic benefit for patients with severe TR.

Strength training improves functional capacity of individuals with chronic heart failure: Randomized clinical trial

IntroductionChronic heart failure (CHF) is characterized by dyspnea, exercise intolerance and impaired quality of life. Physical exercise is a key point in the treatment of these outcomes. ObjectiveTo evaluate the effect of 24 weeks of two different training strategies on functional capacity, muscle strength and quality of life in individuals with CHF. MethodsThe following tests and evaluations were performed before and after 24 weeks of training: exercise test, one-repetition maximum test (1- RM) and Minnesota Living with Heart Failure Questionnaire (MLHFQ). Subjects were randomized according to the modality they would perform first: aerobic training group (ATG – n=6) or strength training group (STG – n=7). ResultsThe sample consisted of 13 individuals (10 men), aged 55 ± 12 years and a left ventricular ejection fraction (LVEF) of 38.8 ± 5.3%. There was a significant increase in V'O 2peak only in STG (STG: 26.92 ± 9.81 vs 30.52 ± 8.39 mL.kg -1 .min -1 - p=0.025; ATG: 19.60 ± 7,00 vs 22.42 ± 8.54 mL.kg -1 .min -1 - p=0.119). Both groups showed significant improvements in muscle strength (STG: 45 ± 17 vs 51 ± 20 kg - p=0.001; ATG: 38 ± 19 vs 42 ± 20 kg - p=0.012). There was no significant difference in quality of life (STG: 30 ± 18 vs 24 ± 20 - p=0.109; ATG: 36 ± 16 vs 26 ± 15 - p=0.143). ConclusionThe early implementation of strength training improves functional capacity and muscle strength of individuals with CHF.

Prevalence and modifiable risk factors of cognitive frailty in patients with chronic heart failure in China: a cross-sectional study

BackgroundCognitive frailty (CF) is currently a significant issue, and most of the associated factors discovered in current studies are not modifiable. Therefore, it is crucial to identify modifiable risk factors that can be targeted for interventions in patients with chronic heart failure (CHF). This study aimed to investigate the prevalence and modifiable risk factors of CF in CHF patients in China.MethodsIn this cross-sectional study, we sequentially enrolled patients diagnosed with CHF. CF served as the dependent variable, assessed through the Montreal Cognitive Assessment (MoCA) Scale and the FRAIL Scale. The independent variable questionnaire encompassed various components, including general demographic information, the Social Support Rating Scale (SSRS), the Simplified Nutrition Appetite Questionnaire (SNAQ), the Hamilton Depression Scale (HAMD), the Hamilton Anxiety Scale (HAMA), and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Logistic regression analysis was employed to identify independent factors contributing to CF.ResultsA total of 271 patients with CHF were included in the study. The overall prevalence of CF was found to be 49.4%, with 28.8% of patients exhibiting potentially reversible cognitive frailty and 20.7% showing reversible cognitive frailty. Among middle-young CHF patients, 10.7% had reversible cognitive frailty and 6.4% had potentially reversible cognitive frailty, with a prevalence of CF at 17.1%. Logistic regression analysis revealed that body mass index (OR = 0.826, 95%CI = 0.726–0.938), blood pressure level (OR = 2.323, 95%CI = 1.105–4.882), nutrition status (OR = 0.820, 95%CI = 0.671–0.979), and social support (OR = 0.745, 95%CI = 0.659–0.842) were independent factors associated with CF (p < 0.05).ConclusionsWe observed a relatively high prevalence of CF among Chinese patients diagnosed with CHF. Many factors including BMI, blood pressure level, nutrition status, and social support emerging as modifiable risk factors associated with CF. We propose conducting clinical trials to assess the impact of modifying these risk factors. The outcomes of this study offer valuable insights for healthcare professionals, guiding them in implementing effective measures to improve the CF status in CHF patients during clinical practice.

Investigation of the efficacy of beta-blockers and reninangiotensin-aldosterone system inhibitors in chronic heart failure with preserved ejection fraction

Purpose: To investigate the clinical effectiveness of beta-blockers (BBs) and renin-angiotensinaldosterone system (RAAS) inhibitors in chronic heart failure with preserved ejection fraction (HFpEF).&#x0D; Methods: 100 patients with HFpEF admitted to The Third Affiliated Hospital of Qiqihar Medical University, China, between April and June  2023 were stratified into five groups. Beta-blocker (BB) group received bisoprolol, angiotensin-converting enzyme inhibitor (ACEI) group  received benazepril hydrochloride, angiotensin II receptor blocker (ARB) group received candesartan, angiotensin receptor neprilysin  inhibitor (ARNI) group received sacubitril valsartan, and mineralocorticoid receptor antagonist (MRA) group received spironolactone.  Differences in clinical effectiveness, six-minute walking distance (6MWD), cardiac functionality, quality of life, and survival rate were  compared among the groups.&#x0D; Results: Beta-blocker group showed the highest efficacy. After treatment, all groups except MRA showed  significant improvement in 6MWD. Also, ACEI, ARB, and ARNI groups exhibited significantly longer 6 MWD than MRA group (p &lt; 0.05). Left  ventricular ejection fraction levels showed significant improvement in the ACEI, ARNI, and MRA groups (p &lt; 0.05), while pulmonary  artery pressure (PAP) decreased in the BB, ACEI, ARNI, and MRA groups (p &lt; 0.05). After treatment, the Minnesota Living with Heart  Failure Questionnaire (MLHFQ) scores of BB, ACEI, ARB, and ARNI groups were significantly lower than before treatment (p &lt; 0.05). All five  groups significantly exhibited decline in NTproBNP levels after treatment (p &lt; 0.05). However, at 18-month follow-up, there was no  significant difference in survival rates among the groups (p &gt; 0.05).&#x0D; Conclusion: Beta-blockers (BBs) and RAAS inhibitors show promising  activity in HFpEF, bisoprolol enhances cardiac function, benazepril improves symptoms, candesartan aids exercise and sacubitril valsartan  elevates cardiac class. However, none of these drugs significantly improves clinical outcomes.  

The Effectiveness of Lifestyle Interventions in Heart Failure With Preserved Ejection Fraction: A Systematic Review and Network Meta-Analysis

AimsTo perform a network meta-analysis to determine the effectiveness of lifestyle interventions on exercise tolerance and quality of life (QoL) in people with HFpEF. METHODSTen databases were searched for randomised controlled trials that evaluated a diet and/or exercise intervention in people with HFpEF up until May 2022. The co-primary outcomes were peak oxygen uptake (V̇O2peak) and QoL as assessed by the Minnesota Living with Heart Failure Questionnaire (MLHFQ). We synthesised data using network meta-analysis. RESULTSThirteen trials were identified including a total of 869 participants and incorporated six different interventions. Improvements in V̇O2peak compared to controls were seen for all exercise interventions (2.88 [95%CI: 1.36; 4.39]ml/kg/min) for high intensity interval training (HIIT); 2.37 [95%CI: 1.02; 3.71] ml/kg/min for low intensity exercise (LIT) combined with a hypocaloric diet; 2.05 [95%CI: 0.81; 3.29]ml/kg/min for moderate intensity continuous training (MICT); 1.94 [95%CI: 0.59; 3.29] ml/kg/min for LIT; 1.85 [95%CI: 0.27; 3.44]ml/kg/min for MICT combined with resistance training) but not a hypocaloric diet alone (1.26 [95%CI: -0.08; 2.61]ml/kg/min). Only HIIT (-14.45 [95%CI: -24.81; -4.10] points) and LIT (95%CI: -11.05 [-20.55; -1.54] ml/kg/min) significantly improved MLHFQ score. Network meta-analysis indicated HIIT was the most effective intervention for improving both V̇O2peak (mean improvement 2.88 [95%CI: 1.36; 4.39]ml/kg/min, follow up (FU) range 4 weeks- 3 years) and QoL (-14.45 [95%CI: -24.81; -4.10] points, FU range 12-26 weeks) compared to usual care. CONCLUSIONSThis network meta-analysis indicates that HIIT is the most effective lifestyle intervention studied to improve exercise capacity and QoL with mean improvements exceeding the minimum clinically meaningful thresholds. HIIT is likely to be an underused management strategy in HFpEF, but further studies are needed to confirm long-term improvements in symptoms and clinical outcomes.

Spiritual Well-Being to the Quality of Life of Heart Failure Patients

Heart failure is caused by the heart being unable to maintain normal blood flow. Some patients with heart failure expressed that they needed nurses' help with their physical, psychological, and spiritual problems. Spiritual Well-Being and its components play an important role in a person's declining quality of life and have been linked to various other health factors. This research aims to determine the relationship between spiritual well-being and the quality of life of heart failure patients. The sample for this research was 100 respondents taken using the accidental sampling technique. Data analysis uses the chi-square correlation test if the test conditions are met. If the test requirements are not met, use the alternative Fisher exact test. The instruments used in this research were the Spiritual Needs Questionnaire (SpNQ) and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). The results of this study illustrate that there is no relationship between quality of life scores and all aspects of the spiritual needs of heart failure patients (p&gt; 0.05). The results of the analysis carried out showed that NYHA functional status (p= 0.044) and ejection fraction (r= -0.205, p= 0.041) influenced the spiritual needs of heart failure patients. The results of this study indicate that the patient's spiritual needs are not related to the general quality of life score, but have a significant relationship with the physiological dimensions of quality of life, ejection fraction, and NYHA functional status.

Quality of life among patients with chronic heart failure in Nam Dinh Province, Vietnam

Background This study aimed to assess the quality of life of patients with chronic heart failure (HF) to improve their treatment and care. Methods This study was conducted to evaluate the quality of life of 89 patients suffering from chronic heart failure and was assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). In addition, the presence of depressive symptoms and perception of social support were also assessed by the Beck Depression Inventory-II (BDI-II) and the Multidimensional Scale of Perceived Social Support (MSPSS). Results Of the 89 HF patients, 53.9% were female and 46.1% were male. The mean age of 89 patients was 62.28±13.26 years old, of which 64% were 60 years old and older. The mean time that patients lived with HF was 8.49±4.59 years. The overall Minnesota Living with Heart Failure Questionnaire mean score was high at 67.19±13.31 points. Regarding personal characteristics, the Minnesota Living with Heart Failure Questionnaire scores were significantly higher in women vs men, widowed/divorced vs being married patients, and patients living alone vs living with family detailed (67.52±11.80 vs 66.80±15.02; p=0.032), (67.58±11.62 vs 65.27±20.11; p=0.000), and (73.3±14.95 vs 66.50±13.04; p=0.014), respectively. Regarding heart failure associated features, the Minnesota Living with Heart Failure Questionnaire scores were significantly higher in patients living with longer heart failure, in more severity of Beck Depression Inventory-II, and lower levels of social support (all p-values of 0.000). Conclusions The results of the study showed a poor quality of life in patients with chronic heart failure and raised concerns about improving the patients’ quality of life.

Comparing the Effects of Face-to-Face and Virtual Self-Care Training Methods on Self‐Care and Quality of Life among Patients with Heart Failure: A Randomized Clinical Trial Study

Background and Objective: Heart failure is one of the most common chronic, progressive, and debilitating heart disorders, exerting a destructive effect on self-care and quality of life in these patients. The present study aimed to compare the effects of face-to-face and virtual self-care training methods on self‐care and quality of life among patients with heart failure. Materials and Methods: This three-group clinical trial study was conducted on 120 patients with heart failure admitted to Farshchian Hospital in Hamadan. The samples were selected via the available sampling method and assigned to three groups (control, virtual, and face-to-face education) using permuted block randomization. Demographic characteristics form, European Heart Failure Self-care Behaviour Scale (EHFScBs), and Minnesota Living with Heart Failure Questionnaire (MLHFQ) were completed by self-report before the intervention. The control group received only the routine training of the clinic, while the face-to-face training group received self-care training in four one-hour group sessions, one day apart. The virtual group received the same amount of education in the form of educational clips, and two months after the intervention, the questionnaires were completed. Chi-square tests, Fisher's exact test, paired t-test, and one-way analysis of variance were used to analyze the data. Results: The results pointed out that before the intervention, there was no statistically significant difference between the demographic variables, self-care, and quality of life of patients in the three groups (P&gt; 0.05). After the intervention, no statistically significant difference was observed between the virtual and face-to-face training groups in terms of self-care and quality of life (P&gt;0.05). Nonetheless, self-care and quality of life were improved in these two groups compared to the control group (P˂0.05). Conclusion: Both virtual and face-to-face training methods had the same effect on self-care and quality of life. Virtual training is a great alternative to face-to-face training in the absence of necessary conditions.

Clinical efficacy and safety of adjunctive treatment of chronic ischemic heart failure with Qishen Yiqi dropping pills: a systematic review and meta-analysis.

Our study was to evaluate the effect of Qishen Yiqi Dropping Pills(QSYQ) on the prognosis of chronic ischemic heart failure(CIHF) and its safety. Databases including CNKI, Wanfang, VIP, CBM, PubMed, Web of Science, The Cochrane Library and EMbase were searched from their inception to April 2023 to screen relevant randomized controlled trials (RCTs). Primary indicators included readmission rates, rates of major adverse cardiovascular events (MACE), and all-cause mortality rates. The quality of the literature was assessed according to the Cochrane Reviewers' Handbook 5.0 and the Modified Jadad Scale (with a score of 4-7 rated as high quality). Meta-analysis was performed using the meta-package created by R software version 4.2.3, continuous data were compared using SMDs, and dichotomous and ordered data were compared using ORs; and the I2 test was used to assess the heterogeneity. Fifty-nine studies out of 1,745 publications were finally included, totalling 6,248 patients. Most studies were poorly designed and had some publication bias, with only 26 high-quality papers (Jadad score ≥4). Meta-analysis showed that the combined application of QSYQ was able to reduce the readmission rate [OR = 0.42, 95% CI (0.33, 0.53), P < 0.001], all-cause mortality rate [OR = 0.43, 95% CI (0.27, 0.68), P < 0.001], and the incidence of MACE [OR = 0.42, 95% CI (0.31, 0.56), P < 0.001]. Also, the treatment method can improve clinical effectiveness [OR = 2.25, 95% CI (1.97, 2.58), P < 0.001], increase 6-min walking distance (6MWD) [SMD = 1.87, 95% CI (1.33, 2.41), P < 0.0001] and left ventricular ejection fraction (LVEF) [SMD = 1.08, 95% CI (0.83, 1.33), P < 0.0001], and decrease the Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores [SMD = -2.03, 95% CI (-3.0, -1.07), P < 0.0001], BNP levels [SMD = -2.07, 95% CI (-2.81, -1.33), P < 0.0001] and NT-ProBNP levels [SMD = -2.77, 95% CI (-4.90, -0.63), P < 0.05]. A total of 21 studies (n = 2,742) evaluated their adverse effects, of which 13 studies reported no adverse effects and 8 studies reported minor adverse effects. Our results suggest that the combined application of QSYQ can further improve patients' cardiac function and exercise tolerance, improve their quality of life, and ultimately improve patients' prognosis with a favorable safety profile. Nonetheless, limited by the quality and high heterogeneity of the literature, we must be conservative and cautious about the present results. PROSPERO (CRD42023449251).

Comparison of the efficacy of combining left bundle branch pacing with either sacubitril/valsartan or enalapril in the treatment of chronic heart failure: A retrospective observational analysis.

To assess the efficacy of left bundle branch pacing (LBBP) combined with either sacubitril/valsartan or enalapril in the treatment of chronic heart failure (CHF). We retrospectively reviewed the records of 138 patients with CHF admitted to Dazhou Central Hospital between June 2020 and June 2022 to extract clinical data. We divided the data into two treatment groups for the analysis: 71 patients received LBBP combined with sacubitril/valsartan treatment (sacubitril/valsartan group), and 67 received LBBP combined with enalapril treatment (enalapril group). The levels of cardiac and cardiopulmonary function indicators, levels of myocardial injury markers, and the scores of the Minnesota Living with Heart Failure Questionnaire (MLHFQ) before and after the treatment were compared between the two groups. After six months of treatment, patients in the sacubitril/valsartan group had lower myocardial injury markers, higher cardiopulmonary function indicators, and lower MLHFQ scores (P<0.05). In CHF patients, the combination of LBBP with sacubitril/valsartan had a better therapeutic effect compared to LBBP with enalapril, with more effective improvement of the cardiopulmonary function, reduction of myocardial injury, and improvement in quality of life.

Health-related quality of life of people with heart failure in low- and middle-income countries: a systematic review and meta-analysis.

Heart failure is a global health concern and associated with poor health-related quality of life and increased mortality. There is a disproportionate burden on patients and health systems in low- and middle-income countries. This systematic review and meta-analysis estimates the health-related quality of life of people with heart failure in low- and middle-income countries. A systematic literature search was conducted to identify relevant studies from January 2012 to November 2022 using the following databases: MEDLINE, EMBASE, PsycINFO, CINAHL, Web of Science, Scopus and JBI EBP database. Study screening, quality appraisal and data extraction were conducted using JBI methodology. A random-effects model was used to perform the meta-analysis. Heterogeneity was assessed using the I2 statistic. All statistical analyses were done in STATA version 17. A total of 33 studies with 5612 participants were included in this review. The Minnesota Living with Heart Failure Questionnaire (MLHFQ) and the Short-Form-36 questionnaire (SF-36) were the most used instruments across 19 and 8 studies, respectively. The pooled mean MLHFQ and SF-36 scores using the random-effects model were 46.08 (95% CI 35.06, 57.10) and 41.23 (95% CI 36.63, 45.83), respectively. In a subgroup analysis using both instruments, the highest health-related quality-of-life scores occurred in studies with inpatient participants. The overall health-related quality of life of people with heart failure in low- and middle-income countries is poor. Strategies should be strategically developed to improve the health-related quality of life of people with heart failure in these countries. PROSPERO CRD42022377781.

Efficacy and Safety of QiShen YiQi Dripping Pills in the Treatment of Coronary Heart Disease Complicating Chronic Heart Failure (Syndrome of Qi Deficiency with Blood Stasis): Study Protocol for a Randomized, Placebo-Controlled, Double-Blind and Multi-Centre Phase II Clinical Trial.

Heart failure (HF) is a serious and terminal stage of various cardiac diseases and the most common complication of coronary heart disease (CHD). Previous clinical studies have shown that Qishen Yiqi dropping pills (QSYQ) have the effect of treating chronic heart failure. This study aims to evaluate the clinical efficacy, safety and optimal effective dose of QSYQ in treating CHD complicating chronic HF with reduced ejection fraction (HFrEF). We will conduct a randomized, double-blind, placebo controlled, multicenter clinical trial. A total of 228 individuals from 16 hospitals in China will be randomly assigned to the low-dose, high-dose, and placebo groups in a ratio of 1:1:1. The trial consists of a screening period (standard medical treatment for at least 2 weeks) and a 12-week treatment period. After randomization, follow-up will be conducted at the 4th, 8th and 12th week. The primary outcomes will be the 6-Minute Walk Test (6MWT) at Week 12. Secondary outcomes will include 6MWT distance at Week 4 and 8, New York Heart Association (NYHA) functional classification, Traditional Chinese Medicine (TCM) Syndrome score, echocardiography indices, N-terminal pro-B-type natriuretic peptide (NT-proBNP), oxyhemoglobin saturation, Minnesota living with heart failure questionnaire (MLHFQ) score, grasp strength body mass index test and cardiovascular adverse events (AE). This trial has been approved by the Research Ethics Committee of the First Affiliated Hospital of Guangzhou University of Chinese Medicine, China (approval number: ZYYEC [2021]005). Written informed consent will be obtained from all participants. The results of this trial will be publicly shared through academic conferences and peer-reviewed journals. Clinical Trials Registry (NCT04983043, Date: 07/08/2021, https://clinicaltrials.gov/ct2/show/NCT04983043).

Minimum clinically important differences in the Minnesota Living with Heart Failure questionnaire: from a study of heart failure patients treated with integrated Chinese and Western medicine

ObjectiveThe purpose of this study was to estimate the minimum clinically important differences (MCIDs) in the Minnesota Living with Heart Failure questionnaire (MLHFQ), which targeted patients with heart failure treated with integrated Chinese and Western medicine, as a means of helping doctors and patients judge the effectiveness of intervention.MethodsA total of 194 patients with chronic heart failure were recruited from three general hospitals in Beijing. Anchor-based and distribution-based approaches were used to estimate MCID. The anchor was SF-36 item 2 (HT, Health Transition), and the calculation methods included the mean change method, receiver operating characteristic (ROC) curve analysis, and linear regression model. For the distribution-based approaches, 0.2, 0.5, and 0.8 standardized response mean (SRM) values and standard error of measurement (SEM) value of 1 were used.ResultsThe correlation coefficients of the MLHFQ scale information and HT were 0.346–0.583. Different MCIDs were obtained by the mean change method, ROC curve, and linear regression model. The minimum MCID in the physical domain, emotional domain, and total scores were 3.6, 2.0, and 7.4, respectively; the maximum estimates were 9.5, 2.5, and 13.0, respectively; and the average estimates were 5.7, 2.2, and 10.0, respectively. The average estimates were close to the result of the 0.5 SRM or 1 SEM.ConclusionWe established MCIDs in the MLHFQ using anchor-based and distribution-based approaches. It was recommended to round the average estimates of anchor-based approaches up to the nearest whole number for the MCIDs of the MLHFQ physical domain, emotional domain, and total scores. The results were 6.0, 2.0, and 10.0, respectively.

Health-related quality of life and its influencing factors among people with heart failure in Ethiopia: using the revised Wilson and Cleary model

Heart failure is a challenging public health problem associated with poor health-related quality of life (HRQoL). Data on the quality of life of people with heart failure are limited in Ethiopia. This study aimed to assess the HRQoL and its influencing factors in people with heart failure in Ethiopia. A hospital-based, cross-sectional study design was conducted in the cardiac outpatient clinics of two tertiary-level hospitals in Addis Ababa, Ethiopia. Data were collected from people with heart failure who met the inclusion criteria using an interviewer-administered questionnaire. The HRQoL was measured using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). A multiple linear regression model was fitted to identify factors that influenced HRQoL. All statistical analyses were conducted using STATA version 17 software. A total of 383 people with heart failure participated in the study. The mean age of the participants was 55 years. The MLHFQ score was 48.03±19.73, and 54% of participants had poor HRQoL. Multiple linear regression analysis revealed that age (β= 0.12, 95% CI 0.11, 0.28), diabetes mellitus comorbidity (β= 4.47, 95% CI 1.41, 7.54), social support score (β= − 1.48, 95% CI − 1.93, − 1.03), and depression score (β = 1.74, 95% CI 1.52, 1.96) were significant factors influencing overall HRQoL (p < 0.05). This study found that people in Ethiopia with heart failure had poor HRQoL, influenced by several factors. The findings can help health professionals identify appropriate interventions to improve the HRQoL of people with heart failure.

Assessment of health-related quality of life in patients with Chagas cardiomyopathy using Minnesota living with heart failure questionnaire: A validation study.

Chagas cardiomyopathy (ChC) is the most severe clinical form of Chagas disease and, in association with psychosocial factors, can compromise the health-related quality of life (HRQoL) of affected patients. To date, there is no specific instrument to assess the HRQoL of these patients, and the Minnesota Living with Heart Failure Questionnaire (MLwHFQ), specific for heart failure, is being used both in research and current clinical practice. Therefore, we aimed to verify the validity of the MLwHFQ in the assessment of HRQoL of patients with ChC. Fifty patients with ChC (50.6 ± 10.1 years, NYHA I-III) were evaluated. The MLwHFQ, Short-Form of Health Survey (SF-36), Beck Depression Inventory (BDI), and Human Activity Profile (HAP) were applied. All patients underwent echocardiography and Cardiopulmonary Exercise Testing (CPET). The MLwHFQ score correlated with almost all SF-36 domains (with r-value ranging from -0.38 to -0.69), except pain (p = 0.118). The MLwHFQ score also correlated with the BDI score (r = 0.748; p < 0.001), HAP score (r = -0.558; p = 0.001), peak oxygen uptake (r = -0.352; p = 0.01), and left ventricular ejection fraction (r = -0.329; p = 0.021). There was no significant difference in the score found on the MLwHFQ among NYHA classes (p = 0.101), as well as between patients with systolic dysfunction (n = 30) and preserved cardiac function (n = 20) (p = 0.058). Similarly, there was no significant difference in the score found on the physical (p = 0.423) and mental (p = 0.858) components of SF-36 between patients with systolic dysfunction and preserved cardiac function (p = 0.271 and p = 0.609, respectively). There was also no difference in the mental component of SF-36 among NYHA classes (p = 0.673). However, the HRQoL using the physical component of SF-36 was worse in advanced NYHA classes (p = 0.014). MLwHF correlated with most SF-36 HRQoL domains, depressive symptoms, physical activity, and systolic function and seems to be valid in assessing the HRQoL of ChC patients.

Clinical and echocardiographic impact of physiological estimulation in patients with preserved ejection fraction: a randomized clinical trial

Abstract Introduction Right ventricular stimulation in the apex (RVAS) produce dysynchrony, leading to left ventricle systolic dysfunction (LVSD) in some cases. Circumstances that can worsen the LVSD are a high burden of RVAS, and the presence of previous LVSD and/or intraventricular conduction disease (IVCD). Direct activation of the specialized conduction system with physiological stimulation (PS) can preserve this physiological pattern and shorten de QRS when the impairment is proximal to the pacing site. Most of the studies with PS has been focused on patients with LVSD, with few and scarce evidences regarding pacients without LVSD. Objectives and methods: This is a parallel, single blinded, unicentric, randomized trial of patients with preserved of mild reduced left ventricular ejection fraction (LVEF) submitted to a pacemaker implantation due to atrioventricular block (AVB), with previous IVCD (wide QRS) an anticipated high rate of ventricular pacing. Patients were randomized 1:1 to RVAS vs PS and followed for 6 months. Clinical, ECG, echocardiography and analytic parameters were compared. The primary endpoint was the change in the LVEF at 6 months in each group. The secondary endpoints were the changes in the left ventricular end-diastolic diameter (LVEDD), the QRS duration, the pro–B-type natriuretic peptide (NT-proBNP), the NYHA class, and the Minnesota Living with Heart Failure Questionnaire (MLWHFQ) in each group. Results The study included 57 patients of 77±9,6 years. Of all patients, 53% were treated with RVAS and 47% with PS. There were 2 patients with crossover to RVAS for technical difficulties and 1 patient with crossover to PS due to apical scar. There were no differences in the basal QRS duration (142.08±20,2 ms), LVEF (58.87±7,2%), NT-proBNP (3336,03±7258,68 pg/ml), or MLWHFQ (22,19±14,68), between both groups (Table 1). Acutely significant differences were observed in the change of QRS duration among groups (+16±29 ms in the RVAS group vs -17±25 ms in the PS group, p&amp;lt;0,001). At 6 months follow-up LVEF showed a non-significant reduction of 0.8±1.1% in the PS group compared to a significant reduction of 5.1±1.7% in the RVAS group (difference 4,26% IC 0,1-8,43 p=0,022). No differences were observed regarding the values of the NT-ProBNP and the MLWHFQ between groups at 6 months (Table 2). Conclusions In patients with preserved LVEF requiring pacemaker implantation for AVB, PS shorten the QTS duration and preserves the LVEF compared to RVAS.Basal characteristics of groupsDifferences in outcomes between groups