Patient-reported outcomes in heart failure with preserved vs. reduced ejection fraction: focus on physical independence.
Patient-reported outcomes in heart failure with preserved vs. reduced ejection fraction: focus on physical independence.
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DOI：
10.1002/ehf2.12950
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发表时间：
2020-10
影响因子：
3.8
通讯作者：
Lam CSP
中科院分区：
文献类型：
--
作者：
Huang W;Teng TK;Tay WT;Richards AM;Kadam U;Lawson CA;Shimizu W;Loh SY;Anand I;Lam CSP
堪萨斯城心肌病问卷（KCCQ）是一种广泛使用的心衰（HF）患者报告的结果测量方法。KCCQ在射血分数降低（HFrEF）的HF患者中得到了验证，对于其在射血分数保持（HFpEF）的HF中的适用性存在知识空白。本研究探讨了HFrEF和HFpEF中KCCQ的内部一致性和信度、结构和已知组效度的心理测量特性。我们的目的是评估KCCQ的心理测量特性及其在HFpEF和HFrEF中的预后意义，在一个大型前瞻性跨国HF队列中。我们在前瞻性跨国亚洲心力衰竭研究中检查了23项KCCQ [4470 HFrEF（射血分数<40%）；921 HFpEF（射血分数≥50%）]。内部一致性（使用Cronbach's alpha）显示HFrEF和HFpeF具有高可靠性：功能状态评分分别为0.89和0.91，临床总结评分分别为0.89和0.90。HFrEF的验证性因子分析证实了KCCQ的五个原始领域（身体功能、症状、自我效能、社会限制和生活质量）；在HFpEF中，测量身体机能和社会限制的问题有很强的相关性（r = 0.66），并且出现了不同的领域。我们提出了一个额外的身体独立性总结评分，特别是在HFpEF（包括原始身体功能和社会限制域）中，该评分显示出良好的内部一致性（α = 0.89），并且在预测1年死亡和/或HF住院方面，受试者工作特征曲线（0.766±0.037）与临床总结评分（受试者工作特征曲线0.774±0.037）具有可比较的相关性。我们的结果证实了无论射血分数如何，KCCQ临床总结评分在HF中的稳健性。我们的研究结果表明，在HFpEF中，身体能力的评估与社会限制有很强的相互作用，我们提出了一个综合评分，包括这两个部分。
The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a widely used patient‐reported outcome measure in heart failure (HF). The KCCQ was validated in patients with HF with reduced ejection fraction (HFrEF), leaving knowledge gaps regarding its applicability in HF with preserved ejection fraction (HFpEF). This study addresses the psychometric properties of internal consistency and reliability, construct, and known‐group validity of KCCQ in both HFrEF and HFpEF. We aimed to evaluate the psychometric properties of the KCCQ and their prognostic significance in HFpEF and HFrEF, within a large prospective multinational HF cohort. We examined the 23‐item KCCQ in the prospective multinational ASIAN‐HF study [4470 HFrEF (ejection fraction <40%); 921 HFpEF (ejection fraction ≥50%)]. Internal consistency (using Cronbach's alpha) showed high reliability in HFrEF and HFpeF: functional status score: 0.89 and 0.91 and clinical summary score: 0.89 and 0.90, respectively. Confirmatory factor analysis in HFrEF validated the five original domains of KCCQ (physical function, symptoms, self‐efficacy, social limitation, and quality of life); in HFpEF, questions measuring physical function and social limitation had strong correlation (r = 0.66) and different domains emerged. We proposed an additional physical independence summary score, especially in HFpEF (comprising the original physical function and social limitation domains), which showed good internal consistency (α = 0.89) and has comparable receiver operating characteristic curve 0.766 ± 0.037 with the clinical summary score (receiver operating characteristic curve 0.774 ± 0.037), in predicting 1 year death and/or HF hospitalization. Our results confirmed the robustness of the KCCQ clinical summary score in HF regardless of ejection fraction group. In the assessment of physical capacity in HFpEF, our results suggest strong interaction with social limitation, and we propose a summary score comprising both components be used.
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影响因子：
15.8
作者：
Lawson CA;Solis-Trapala I;Dahlstrom U;Mamas M;Jaarsma T;Kadam UT;Stromberg A
通讯作者：
Stromberg A
影响因子：
4.8
作者：
Luo N;Teng TK;Tay WT;Anand IS;Kraus WE;Liew HB;Ling LH;O'Connor CM;Piña IL;Richards AM;Shimizu W;Whellan DJ;Yap J;Lam CSP;Mentz RJ;ASIAN-HF;HF-ACTION investigators
通讯作者：
HF-ACTION investigators
影响因子：
4.6
作者：
Garin, Olatz;Herdman, Michael;Alonso, Jordi
通讯作者：
Alonso, Jordi
影响因子：
18.2
作者：
Chioncel, Ovidiu;Lainscak, Mitja;Filippatos, Gerasimos
通讯作者：
Filippatos, Gerasimos
影响因子：
15.8
作者：
Tromp J;Tay WT;Ouwerkerk W;Teng TK;Yap J;MacDonald MR;Leineweber K;McMurray JJV;Zile MR;Anand IS;Richards AMR;Lam CSP;ASIAN-HF authors
通讯作者：
ASIAN-HF authors