The Impact of B‐type Natriuretic Peptide, New York Heart Association Classification and Depression on Quality of Life in Nonhospitalized Heart Failure Patients

Abstract

Healthcare providers should be concerned with improving the quality of life (QOL) of patients with heart failure (HF) because disease-specific QOL is linked to disease progression. The present study investigated the significance of elevated b-type natriuretic peptide (BNP), NYHA classification and depression to HF-related QOL to develop better management strategies. Outpatient subjects with left ventricular systolic dysfunction (n=108; mean age=64.9+/-12) completed the self-administered Minnesota Living with Heart Failure questionnaire and the Center for Epidemiologic Studies Depression Scale. Functional status was measured using the New York Heart Association Classification (NYHA) and BNP concentrations were measured in plasma samples. Multiregression analysis determined that plasma BNP levels did not contribute significantly to the total QOL score while depression (r=0.63, t ratio=7.43, P<.0001) and NHYA class (r=0.47, t ratio=3.31, P<.001) were significant contributors. NYHA III subjects exhibited worse depression scores (II 15+/-7 and III: 22+/-10, P<.001) and elevated plasma BNP (II: 2.0+/-0.5 and III: 2.4+/-0.6, P<.001). Low-cost psychological assessments are recommended to evaluate depression and suggest that those HF patients with NYHA III be closely monitored for depression and reduced QOL.

Mediating Role of Daily Physical Activity on Quality of Life in Patients With Heart Failure

“…Their results showed a mean for each item that ranged from 1.8 to 2.8, indicating that the clinical manifestations of heart disease had an impact on quality of life. 26 In a US study, the mean of the total score for quality of life was 48, 30 which was higher than the mean of 23 found in the present study. This indicates that the patients in our study experienced a lower impact from their disease on their quality of life.…”

Depressive Symptom Trajectory Predicts 1-Year Health-Related Quality of Life in Patients With Heart Failure

“…Other researchers examining the relationship between depressive symptoms and HRQOL in patients with HF in cross-sectional studies have identified depressive symptoms as an independent predictor of HRQOL. 2,7–10 Similar to our study, these investigators measured HRQOL using HF-specific measures—either the Minnesota Living with HF questionnaire or the Kansas City Cardiomyopathy questionnaire. In one cross-sectional study, Faller et al 32 evaluated depressive symptoms, NYHA functional status, and HRQOL in outpatients with HF.…”

“…2 This hypothesis is based on results from multiple cross-sectional studies showing that depressive symptoms measured at baseline independently predict baseline HRQOL in patients with HF. 2,7–10 Although few investigators have examined the natural trajectory of depressive symptoms in patients with HF, 11–14 the severity of depressive symptoms may vary over time. It is not known whether a positive or negative change in depressive symptoms over time leads to a parallel change in HRQOL.…”

Validation of the FEW16 questionnaire for the assessment of physical well‐being in patients with heart failure with reduced ejection fraction: results from the CIBIS‐ELD study

“…The FEW16 should be used on a larger and—regarding NYHA class—more heterogeneous sample to generate conclusive findings. The significant correlation of major depression with all FEW16 scores reflects the negative impact of depressed mood on the physical and psychological dimension of QoL in HF patients found earlier . Age and sex did not significantly correlate with any FEW16 score.…”