Relationships between changes in patient-reported health status and functional capacity in outpatients with heart failure - 14/12/11

Doi : 10.1016/j.ahj.2011.09.027

Kathryn E. Flynn, PhD ^a,^b,^{^{i
For the HF-ACTION Investigators. See the online Appendix for a complete listing of the HF-ACTION Investigators.},}^{^⁎} , Li Lin, MS ^a,^{^{i
For the HF-ACTION Investigators. See the online Appendix for a complete listing of the HF-ACTION Investigators.}}, Gordon W. Moe, MD ^c,^{^{i
For the HF-ACTION Investigators. See the online Appendix for a complete listing of the HF-ACTION Investigators.}}, Jonathan G. Howlett, MD ^d,^{^{i
For the HF-ACTION Investigators. See the online Appendix for a complete listing of the HF-ACTION Investigators.}}, Lawrence J. Fine, MD, DrPH ^e,^{^{i
For the HF-ACTION Investigators. See the online Appendix for a complete listing of the HF-ACTION Investigators.}}, John A. Spertus, MD, MPH ^f, Timothy R. McConnell, PhD ^g, Ileana L. Piña, MD, MPH ^h,^{^{i
For the HF-ACTION Investigators. See the online Appendix for a complete listing of the HF-ACTION Investigators.}}, Kevin P. Weinfurt, PhD ^a,^b,^{^{i
For the HF-ACTION Investigators. See the online Appendix for a complete listing of the HF-ACTION Investigators.}}
^a Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC
^b Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
^c St Michael's Hospital, Toronto, Ontario, Canada
^d University of Calgary, Calgary, Alberta, Canada
^e Division of Prevention and Population Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD
^f Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, MO
^g Department of Exercise Science, Bloomsburg University, Bloomsburg, PA
^h Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH

^⁎Reprint requests: Kathryn E. Flynn, PhD, Duke Clinical Research Institute, PO Box 17969, Durham, NC 27715.

Résumé

Background

Heart failure trials use a variety of measures of functional capacity and quality of life. Lack of formal assessments of the relationships between changes in multiple aspects of patient-reported health status and measures of functional capacity over time limits the ability to compare results across studies.

Methods

Using data from HF-ACTION (N = 2331), we used the Pearson correlation coefficients and predicted change scores from linear mixed-effects modeling to demonstrate the associations between changes in patient-reported health status measured with the EQ-5D visual analog scale and the Kansas City Cardiomyopathy Questionnaire (KCCQ) and changes in peak VO₂ and 6-minute walk distance at 3 and 12 months. We examined a 5-point change in KCCQ within individuals to provide a framework for interpreting changes in these measures.

Results

After adjustment for baseline characteristics, correlations between changes in the visual analog scale and changes in peak VO₂ and 6-minute walk distance ranged from 0.13 to 0.28, and correlations between changes in the KCCQ overall and subscale scores and changes in peak VO₂ and 6-minute walk distance ranged from 0.18 to 0.34. A 5-point change in KCCQ was associated with a 2.50-mL kg⁻¹ min⁻¹ change in peak VO₂ (95% CI 2.21-2.86) and a 112-m change in 6-minute walk distance (95% CI 96-134).

Conclusions

Changes in patient-reported health status are not highly correlated with changes in functional capacity. Our findings generally support the current practice of considering a 5-point change in the KCCQ within individuals to be clinically meaningful.

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Plan

Methods

Patient-reported health status

Functional capacity

Patient characteristics

	Leslee J. Shaw, PhD served as guest editor for this article.
	Randomized controlled trial registration: clinicaltrials.gov identifier: NCT00047437.
	Funding/support: HF-ACTION was funded by grants 5U01HL063747, 5U01HL066461, 5U01HL068973, 5U01HL066501, 5U01HL066482, 5U01HL064250, 5U01HL066494, 5U01HL064257, 5U01HL066497, 5U01HL068980, 5U01HL064265, 5U01HL066491, and 5U01HL064264 from the National Heart, Lung, and Blood Institute and grants R37AG018915 and P60AG010484 from the National Institute on Aging.

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Vol 163 - N° 1

P. 88 - janvier 2012 Retour au numéro

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Relationships between changes in patient-reported health status and functional capacity in outpatients with heart failure - 14/12/11

Résumé

Background

Methods

Results

Conclusions

Plan

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