PMID- 21450593 OWN - NLM STAT- MEDLINE DCOM- 20120312 LR - 20151119 IS - 1741-8275 (Electronic) IS - 1741-8267 (Linking) VI - 18 IP - 6 DP - 2011 Dec TI - Additive prognostic value of subjective assessment with respect to clinical cardiological data in patients with chronic heart failure. PG - 836-42 LID - 10.1177/1741826711398804 [doi] AB - BACKGROUND: Health-related quality of life tools that better reflect the unique subjective perception of heart failure (HF) are needed for patients with this disorder. The aim of this study was to explore whether subjective satisfaction of HF patients about daily life may provide additional prognostic information with respect to clinical cardiological data. METHODS: One hundred and seventy-eight patients (age 51 +/- 9 years) with moderate to severe HF [New York Heart Association (NYHA) class 2.0 +/- 0.7; left ventricular ejection fraction (LVEF) 29 +/- 8%] in stable clinical condition underwent a standard clinical evaluation and compiled the Satisfaction Profile (SAT-P) questionnaire focusing on subjective satisfaction with daily life. Cox regression analysis was used to assess whether SAT-P factors (psychological functioning, physical functioning, work, sleep/eating/leisure, social functioning) had any prognostic value. RESULTS: Forty-six cardiac deaths occurred during a median of 30 months. Patients who died had higher NYHA class, more depressed left ventricular function, reduced systolic blood pressure (SBP), increased heart rate (HR), and worse biochemistry (all p < 0.05). Among the SAT-P factors, only physical functioning (PF) was significantly reduced in the patients who died (p = 0.003). Using the best subset selection procedure, resistance to physical fatigue (RPF) was selected from among the items of the PF factor. RPF showed independent predictive value when entered into a prognostic model including NYHA class, LVEF, SBP, and HR with an adjusted hazard ratio of 0.86 per 10 units increase (95% CI 0.75-0.98, p = 0.02). CONCLUSIONS: Patients' dissatisfaction with physical functioning is associated with reduced long-term survival, after adjustment for known risk factors in HF. Given its user-friendly structure, simplicity, and significant prognostic value, the RPF score may represent a useful instrument in clinical practice. FAU - Majani, Giuseppina AU - Majani G AD - Psychology Unit, Scientific Institute of Montescano, Salvatore Maugeri Foundation IRCCS, Pavia, Italy. giuseppina.majani@fsm.it FAU - Pierobon, Antonia AU - Pierobon A FAU - Pinna, Gian Domenico AU - Pinna GD FAU - Giardini, Anna AU - Giardini A FAU - Maestri, Roberto AU - Maestri R FAU - La Rovere, Maria Teresa AU - La Rovere MT LA - eng PT - Journal Article DEP - 20110228 PL - England TA - Eur J Cardiovasc Prev Rehabil JT - European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology JID - 101192000 RN - 0 (Biomarkers) SB - IM MH - *Activities of Daily Living MH - Adult MH - Analysis of Variance MH - Biomarkers/blood MH - Blood Pressure MH - Chi-Square Distribution MH - Chronic Disease MH - Female MH - Heart Failure/*diagnosis/mortality/physiopathology/psychology MH - Heart Rate MH - Humans MH - Italy/epidemiology MH - Kaplan-Meier Estimate MH - Male MH - Middle Aged MH - *Patient Satisfaction MH - Predictive Value of Tests MH - Prognosis MH - Proportional Hazards Models MH - Prospective Studies MH - *Quality of Life MH - Risk Assessment MH - Risk Factors MH - Severity of Illness Index MH - Stroke Volume MH - *Surveys and Questionnaires MH - Ventricular Function, Left EDAT- 2011/04/01 06:00 MHDA- 2012/03/13 06:00 CRDT- 2011/04/01 06:00 PHST- 2011/04/01 06:00 [entrez] PHST- 2011/04/01 06:00 [pubmed] PHST- 2012/03/13 06:00 [medline] AID - 1741826711398804 [pii] AID - 10.1177/1741826711398804 [doi] PST - ppublish SO - Eur J Cardiovasc Prev Rehabil. 2011 Dec;18(6):836-42. doi: 10.1177/1741826711398804. Epub 2011 Feb 28.