Health Related Quality of Life in Heart Failure Patients with Improved Ejection Fraction

Background In a subset of patients with heart failure with reduced ejection fraction (HFrEF) disease modifying therapy results in improvement of left ventricular EF (HFiEF). Yet, it has been noted that HFiEF patients may experience clinical events exceeding that of a healthy population. Our aim was to examine health-related quality of life (hrQOL) in HFiEF and compare it to those with HFrEF and HF with preserved ejection fraction (HFpEF). Methods In a large HF clinic, hrQOL was routinely assessed using the disease-specific 12-question Kansas City Cardiomyopathy Questionnaire (KCCQ-12), the visual analogue scale (VAS) and the Patient-Reported Outcomes Measurement Information System (PROMIS) scale in the domains of physical function, fatigue, depression, and satisfaction with social roles and activities. HFrEF was defined as LVEF Results The study population consisted of 1,337 patients, average age was 59±16.6 years and 65% were male. The demographics of patients in the three groups of interest - HFiEF (N=181), HFrEF (N=878) and HFpEF (n=318) are shown in Table 1 . Compared to HFrEF and HFpEF, patients with HFiEF had better scores for KCCQ, PROMIS physical function and fatigue (p Figure 1 . HFiEF also had better score for VAS compared to HFrEF (p=0.002). There were no significant differences between scores for PROMIS depression and satisfaction with social roles among the three groups (p=NS). Despite the overall better hrQOL profile, HFiEF PROMIS scores remained below the population median. Summary Our results indicate that HFiEF patients have overall better hrQOL than patients with HFrEF and HFpEF. However, their hrQOL remains below that of the general population. More study is needed to determine the causes of these limitations and ways to further improve hrQOL in HFiEF patients.