Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Winter, S.
Physical capacity determines physical and mental quality of life in patients with
chronic heart failure - a case control study
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2023. pp. 65
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Verheyen Nicolas Dominik
- von Lewinski Dirk
- Altmetrics:
- Abstract:
- Background Chronic heart failure impacts quality of life, yet the underlying connections remain unclear. This study explores quality of life disparities between heart failure patients and healthy individuals. It also investigates whether conventional heart failure parameters (LVEF and NT-proBNP) or walking speed tests are superior predictors for mental and physical quality of life in both groups. Methods A cross-sectional analysis with a case-control design was conducted using two cohorts: RoC-HF (n=205) and BioPersMed (n=1022) from the Medical University of Graz. The case cohort comprised heart failure patients with LVEF <50%, while the control cohort included apparently healthy individuals with at least one cardiovascular risk factor. Parameters, such as echocardiography, laboratory tests, physical performance (Biopersmed: 6MWD; RoC-HF: 4MGS), and SF-36 health survey, were measured. Bivariate and multivariate analyses explored associations between quality of life, LVEF, NT-proBNP, and physical capacity. Results Cases and controls were age, sex, and BMI matched, resulting in cohorts of 188 individuals each. Median NT-proBNP and LVEF were 965 (325-2183) pg/ml and 37 (30-44)% in cases and 72 (33-118) pg/ml and 64 (60-68)% in controls. Cases exhibited lower SF-36 scores in all eight dimensions. Conventional heart failure measures showed minimal to no associations with SF-36 scales. In the heart failure cohort, physical capacity correlated significantly with seven out of eight SF-36 subscales and PCS/MCS. In the healthy cohort, significant correlations were found with three subscales and PCS. Multivariate regression analyses in both cohorts showed 4MGS significantly associated with MCS (beta 0.249, P=0.005) and PCS (beta=0.298, p<0.001) in cases, while LVEF, NT-proBNP, and TAPSE had no significant associations. In controls, 6MWD was significantly associated with PCS (beta=0.280, p<0.001) but not with MCS (p=0.859). Conclusion This study shows, that conventional heart failure parameters poorly predict quality of life. Physical performance, assessed through walking speed tests, emerged as a meaningful predictor of quality of life in heart failure. Recognizing the growing relevance of quality of life in heart failure care, evaluating and enhancing physical performance should be an important component of heart failure management. Walking tests could play a vital role in routine heart failure check-ups due to their rapid, cost-effective, and widespread applicability.