Prospective evaluation of the association between hemoglobin concentration and quality of life in patients with heart failure

Kirkwood F. Adams, Ileana L. Pina, Jalal K. Ghali, Lynne E. Wagoner, Stephanie H. Dunlap, Todd A. Schwartz, Wendy Gattis Stough, Mandeep R. Mehra, Gary Michael Felker, Jun R. Chiong, James Herbert Patterson, John Kim, Javed Butler, Ron M. Oren

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background: Reduced hemoglobin has been associated with adverse outcomes in heart failure, but the relationship of hemoglobin to health-related quality of life in outpatients with this syndrome has not been well studied. Methods: We used data from the prospective, observational Study of Anemia in a Heart Failure Population Registry, which randomly selected outpatients with heart failure from specialty or community cardiology clinics. Hemoglobin was determined by finger stick at baseline and during medically indicated follow-up visits. Health-related quality of life was assessed using the Kansas City Cardiomyopathy Questionnaire and the Minnesota Living with Heart Failure Questionnaire at 3-month intervals for 12 months. Results: Adjusted regression analysis demonstrated a significant, direct, linear relationship between hemoglobin and health-related quality of life from baseline through 12 months follow-up on all Kansas City Cardiomyopathy Questionnaire domains (all P < .001) and the Summary and Physical domains of the Minnesota Living with Heart Failure Questionnaire (all P < .05). Adjusted categorical analysis of the change in Kansas City Cardiomyopathy Questionnaire Clinical scores associated with change in hemoglobin from baseline to 6 months also showed a significant relationship between increasing hemoglobin and improved health status (5.9 ± 1.8 units for a hemoglobin increase of ≥1 g/dL, 0.7 ± 1.2 units for change in hemoglobin <1 g/dL, and -2.6 ± 1.4 units for a ≥1 g/dL decrease in hemoglobin, P < .001). Conclusions: These prospective, observational results indicate that reduced hemoglobin is associated with poorer quality of life in patients with heart failure. Additional studies will be required to establish if this is a cause-and-effect relationship.

Original languageEnglish (US)
Pages (from-to)965-971
Number of pages7
JournalAmerican Heart Journal
Volume158
Issue number6
DOIs
StatePublished - Dec 2009
Externally publishedYes

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Hemoglobins
Heart Failure
Quality of Life
Cardiomyopathies
Outpatients
Cardiology
Health Status
Fingers
Observational Studies
Registries
Anemia
Regression Analysis
Surveys and Questionnaires
Prospective Studies
Population

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Adams, K. F., Pina, I. L., Ghali, J. K., Wagoner, L. E., Dunlap, S. H., Schwartz, T. A., ... Oren, R. M. (2009). Prospective evaluation of the association between hemoglobin concentration and quality of life in patients with heart failure. American Heart Journal, 158(6), 965-971. https://doi.org/10.1016/j.ahj.2009.10.015

Prospective evaluation of the association between hemoglobin concentration and quality of life in patients with heart failure. / Adams, Kirkwood F.; Pina, Ileana L.; Ghali, Jalal K.; Wagoner, Lynne E.; Dunlap, Stephanie H.; Schwartz, Todd A.; Stough, Wendy Gattis; Mehra, Mandeep R.; Felker, Gary Michael; Chiong, Jun R.; Patterson, James Herbert; Kim, John; Butler, Javed; Oren, Ron M.

In: American Heart Journal, Vol. 158, No. 6, 12.2009, p. 965-971.

Research output: Contribution to journalArticle

Adams, KF, Pina, IL, Ghali, JK, Wagoner, LE, Dunlap, SH, Schwartz, TA, Stough, WG, Mehra, MR, Felker, GM, Chiong, JR, Patterson, JH, Kim, J, Butler, J & Oren, RM 2009, 'Prospective evaluation of the association between hemoglobin concentration and quality of life in patients with heart failure', American Heart Journal, vol. 158, no. 6, pp. 965-971. https://doi.org/10.1016/j.ahj.2009.10.015
Adams, Kirkwood F. ; Pina, Ileana L. ; Ghali, Jalal K. ; Wagoner, Lynne E. ; Dunlap, Stephanie H. ; Schwartz, Todd A. ; Stough, Wendy Gattis ; Mehra, Mandeep R. ; Felker, Gary Michael ; Chiong, Jun R. ; Patterson, James Herbert ; Kim, John ; Butler, Javed ; Oren, Ron M. / Prospective evaluation of the association between hemoglobin concentration and quality of life in patients with heart failure. In: American Heart Journal. 2009 ; Vol. 158, No. 6. pp. 965-971.
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abstract = "Background: Reduced hemoglobin has been associated with adverse outcomes in heart failure, but the relationship of hemoglobin to health-related quality of life in outpatients with this syndrome has not been well studied. Methods: We used data from the prospective, observational Study of Anemia in a Heart Failure Population Registry, which randomly selected outpatients with heart failure from specialty or community cardiology clinics. Hemoglobin was determined by finger stick at baseline and during medically indicated follow-up visits. Health-related quality of life was assessed using the Kansas City Cardiomyopathy Questionnaire and the Minnesota Living with Heart Failure Questionnaire at 3-month intervals for 12 months. Results: Adjusted regression analysis demonstrated a significant, direct, linear relationship between hemoglobin and health-related quality of life from baseline through 12 months follow-up on all Kansas City Cardiomyopathy Questionnaire domains (all P < .001) and the Summary and Physical domains of the Minnesota Living with Heart Failure Questionnaire (all P < .05). Adjusted categorical analysis of the change in Kansas City Cardiomyopathy Questionnaire Clinical scores associated with change in hemoglobin from baseline to 6 months also showed a significant relationship between increasing hemoglobin and improved health status (5.9 ± 1.8 units for a hemoglobin increase of ≥1 g/dL, 0.7 ± 1.2 units for change in hemoglobin <1 g/dL, and -2.6 ± 1.4 units for a ≥1 g/dL decrease in hemoglobin, P < .001). Conclusions: These prospective, observational results indicate that reduced hemoglobin is associated with poorer quality of life in patients with heart failure. Additional studies will be required to establish if this is a cause-and-effect relationship.",
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AU - Pina, Ileana L.

AU - Ghali, Jalal K.

AU - Wagoner, Lynne E.

AU - Dunlap, Stephanie H.

AU - Schwartz, Todd A.

AU - Stough, Wendy Gattis

AU - Mehra, Mandeep R.

AU - Felker, Gary Michael

AU - Chiong, Jun R.

AU - Patterson, James Herbert

AU - Kim, John

AU - Butler, Javed

AU - Oren, Ron M.

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N2 - Background: Reduced hemoglobin has been associated with adverse outcomes in heart failure, but the relationship of hemoglobin to health-related quality of life in outpatients with this syndrome has not been well studied. Methods: We used data from the prospective, observational Study of Anemia in a Heart Failure Population Registry, which randomly selected outpatients with heart failure from specialty or community cardiology clinics. Hemoglobin was determined by finger stick at baseline and during medically indicated follow-up visits. Health-related quality of life was assessed using the Kansas City Cardiomyopathy Questionnaire and the Minnesota Living with Heart Failure Questionnaire at 3-month intervals for 12 months. Results: Adjusted regression analysis demonstrated a significant, direct, linear relationship between hemoglobin and health-related quality of life from baseline through 12 months follow-up on all Kansas City Cardiomyopathy Questionnaire domains (all P < .001) and the Summary and Physical domains of the Minnesota Living with Heart Failure Questionnaire (all P < .05). Adjusted categorical analysis of the change in Kansas City Cardiomyopathy Questionnaire Clinical scores associated with change in hemoglobin from baseline to 6 months also showed a significant relationship between increasing hemoglobin and improved health status (5.9 ± 1.8 units for a hemoglobin increase of ≥1 g/dL, 0.7 ± 1.2 units for change in hemoglobin <1 g/dL, and -2.6 ± 1.4 units for a ≥1 g/dL decrease in hemoglobin, P < .001). Conclusions: These prospective, observational results indicate that reduced hemoglobin is associated with poorer quality of life in patients with heart failure. Additional studies will be required to establish if this is a cause-and-effect relationship.

AB - Background: Reduced hemoglobin has been associated with adverse outcomes in heart failure, but the relationship of hemoglobin to health-related quality of life in outpatients with this syndrome has not been well studied. Methods: We used data from the prospective, observational Study of Anemia in a Heart Failure Population Registry, which randomly selected outpatients with heart failure from specialty or community cardiology clinics. Hemoglobin was determined by finger stick at baseline and during medically indicated follow-up visits. Health-related quality of life was assessed using the Kansas City Cardiomyopathy Questionnaire and the Minnesota Living with Heart Failure Questionnaire at 3-month intervals for 12 months. Results: Adjusted regression analysis demonstrated a significant, direct, linear relationship between hemoglobin and health-related quality of life from baseline through 12 months follow-up on all Kansas City Cardiomyopathy Questionnaire domains (all P < .001) and the Summary and Physical domains of the Minnesota Living with Heart Failure Questionnaire (all P < .05). Adjusted categorical analysis of the change in Kansas City Cardiomyopathy Questionnaire Clinical scores associated with change in hemoglobin from baseline to 6 months also showed a significant relationship between increasing hemoglobin and improved health status (5.9 ± 1.8 units for a hemoglobin increase of ≥1 g/dL, 0.7 ± 1.2 units for change in hemoglobin <1 g/dL, and -2.6 ± 1.4 units for a ≥1 g/dL decrease in hemoglobin, P < .001). Conclusions: These prospective, observational results indicate that reduced hemoglobin is associated with poorer quality of life in patients with heart failure. Additional studies will be required to establish if this is a cause-and-effect relationship.

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