PMID- 36484254
OWN - NLM
STAT- MEDLINE
DCOM- 20230119
LR  - 20230213
IS  - 1941-7705 (Electronic)
IS  - 1941-7713 (Linking)
VI  - 16
IP  - 1
DP  - 2023 Jan
TI  - Patient-Reported Versus Physician-Assessed Health Status in Heart Failure With 
      Reduced and Preserved Ejection Fraction From ASIAN-HF Registry.
PG  - e009134
LID - 10.1161/CIRCOUTCOMES.122.009134 [doi]
AB  - BACKGROUND: We aimed to assess if discordance between patient-reported Kansas 
      City Cardiomyopathy Questionnaire (KCCQ)-overall summary (os) score and 
      physician-assessed New York Heart Association (NYHA) class is common among 
      patients with heart failure (HF) with reduced or preserved ejection fraction, and 
      determine its association with outcomes. METHODS: A total of 4818 patients with 
      HF were classified according to KCCQ-os score (range 0-100, dichotomized by 
      median value 71.9 into high [good] versus low [bad]) and NYHA class (I/II [good] 
      or III/IV [bad]) as concordant good (low NYHA class, high KCCQ-os score), 
      concordant bad (high NYHA class, low KCCQ-os score), discordant worse NYHA class 
      (high NYHA class, high KCCQ-os score), and discordant worse KCCQ-os score (low 
      NYHA class, low-KCCQ-os score). The composite of HF hospitalization or death at 1 
      year was compared across groups. RESULTS: There were 2070 (43.0%) concordant 
      good, 1099 (22.8%) concordant bad, 331 (6.9%) discordant worse NYHA class, and 
      1318 (27.4%) discordant worse KCCQ-os score patients. Compared with concordant 
      good, adverse outcomes were the highest in concordant bad (HR, 2.7 [95% CI, 
      2.2-3.5]) followed by discordant worse KCCQ-os score (HR, 1.8 [95% CI, 1.4-2.2]) 
      and discordant worse NYHA class (HR, 1.5 [95% CI, 1.0-2.3]); with no modification 
      by HF phenotype (preserved versus reduced ejection fraction, 
      P(interaction)=0.52). At 6 months, 1403 (48%) experienced clinically significant 
      improvement in KCCQ-os score (>/=5 points increase over 6 months). Patients with 
      improved KCCQ-os at 6 months (HR, 0.65 [95% CI, 0.47-0.92]) had better outcomes 
      and the association was not modified by HF phenotype (P(interaction)=0.40). 
      CONCLUSIONS: One-third of patients with HF had discordance between 
      patient-reported and clinician-assessed health status, largely attributable to 
      worse patient-reported outcomes. Such discordance, particularly in those with 
      discordantly worse KCCQ, should alert physicians to an increased risk of HF 
      hospitalization and death, and prompt further assessment for potential drivers of 
      worse patient-reported outcomes relative to physicians' assessment.
FAU - Teramoto, Kanako
AU  - Teramoto K
AUID- ORCID: 0000-0002-4217-9497
AD  - National Heart Centre Singapore (K.T., W.T.T., J.T., T.-H.K.T., C.C., W.O., W.H., 
      C.S.P.L.).
AD  - National Cerebral and Cardiovascular Center, Osaka, Japan (K.T.).
FAU - Tay, Wan Ting
AU  - Tay WT
AUID- ORCID: 0000-0003-2397-5946
AD  - National Heart Centre Singapore (K.T., W.T.T., J.T., T.-H.K.T., C.C., W.O., W.H., 
      C.S.P.L.).
FAU - Tromp, Jasper
AU  - Tromp J
AD  - National Heart Centre Singapore (K.T., W.T.T., J.T., T.-H.K.T., C.C., W.O., W.H., 
      C.S.P.L.).
AD  - Saw Swee Hock School of Public Health National University of Singapore and the 
      National University Health System (J.T.).
FAU - Katherine Teng, Tiew-Hwa
AU  - Katherine Teng TH
AUID- ORCID: 0000-0002-8431-9961
AD  - National Heart Centre Singapore (K.T., W.T.T., J.T., T.-H.K.T., C.C., W.O., W.H., 
      C.S.P.L.).
AD  - School of Allied Health, University of Western Australia, Perth, Australia 
      (T.-H.K.T.).
FAU - Chandramouli, Chanchal
AU  - Chandramouli C
AUID- ORCID: 0000-0001-8256-902X
AD  - National Heart Centre Singapore (K.T., W.T.T., J.T., T.-H.K.T., C.C., W.O., W.H., 
      C.S.P.L.).
AD  - Duke-NUS Medical School, Singapore (J.T., T.-H.K.T., C.C., C.S.P.L.).
FAU - Ouwerkerk, Wouter
AU  - Ouwerkerk W
AUID- ORCID: 0000-0002-2000-9358
AD  - National Heart Centre Singapore (K.T., W.T.T., J.T., T.-H.K.T., C.C., W.O., W.H., 
      C.S.P.L.).
AD  - Amsterdam Medical Center, Department of Dermatology, The Netherlands (W.O.).
FAU - Lawson, Claire A
AU  - Lawson CA
AUID- ORCID: 0000-0003-0127-5236
AD  - Department of Cardiovascular Research, University of Leicester, United Kingdom 
      (C.A.L.).
FAU - Huang, Weiting
AU  - Huang W
AUID- ORCID: 0000-0003-3453-2374
AD  - National Heart Centre Singapore (K.T., W.T.T., J.T., T.-H.K.T., C.C., W.O., W.H., 
      C.S.P.L.).
FAU - Hung, Chung-Lieh
AU  - Hung CL
AUID- ORCID: 0000-0002-2858-3493
AD  - Mackay Memorial Hospital, Taipei, Taiwan (C.-L.H.).
FAU - Chopra, Vijay
AU  - Chopra V
AUID- ORCID: 0000-0001-9512-1718
AD  - Max Super Specialty Hospital, New Delhi, India (V.C.).
FAU - Anand, Inder
AU  - Anand I
AUID- ORCID: 0000-0003-1308-4963
AD  - Cardiovascular division, University of Minnesota, Minneapolis (I.A.).
FAU - Mark Richards, Arthur
AU  - Mark Richards A
AUID- ORCID: 0000-0002-2023-8177
AD  - Cardiovascular Research Institute, National University of Singapore (A.M.R.).
AD  - Christchurch Heart Institute, University of Otago, New Zealand (A.M.R.).
FAU - Lam, Carolyn S P
AU  - Lam CSP
AUID- ORCID: 0000-0003-1903-0018
AD  - National Heart Centre Singapore (K.T., W.T.T., J.T., T.-H.K.T., C.C., W.O., W.H., 
      C.S.P.L.).
AD  - Duke-NUS Medical School, Singapore (J.T., T.-H.K.T., C.C., C.S.P.L.).
AD  - Department of Cardiology, University Medical Center Groningen, The Netherlands 
      (C.S.P.L.).
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20221209
PL  - United States
TA  - Circ Cardiovasc Qual Outcomes
JT  - Circulation. Cardiovascular quality and outcomes
JID - 101489148
SB  - IM
MH  - Humans
MH  - *Quality of Life
MH  - Stroke Volume
MH  - *Heart Failure/diagnosis/therapy/etiology
MH  - Health Status
MH  - Registries
MH  - Patient Reported Outcome Measures
OTO - NOTNLM
OT  - Kansas City Cardiomyopathy Questionnaire
OT  - New York Heart Association class
OT  - cardiomyopathy
OT  - patient-reported outcome
OT  - physician-assessed heart failure
EDAT- 2022/12/10 06:00
MHDA- 2023/01/20 06:00
CRDT- 2022/12/09 05:03
PHST- 2022/12/10 06:00 [pubmed]
PHST- 2023/01/20 06:00 [medline]
PHST- 2022/12/09 05:03 [entrez]
AID - 10.1161/CIRCOUTCOMES.122.009134 [doi]
PST - ppublish
SO  - Circ Cardiovasc Qual Outcomes. 2023 Jan;16(1):e009134. doi: 
      10.1161/CIRCOUTCOMES.122.009134. Epub 2022 Dec 9.