Relationships between changes in patient-reported health status and functional capacity in outpatients with heart failure

Kathryn E. Flynn, Li Lin, Gordon W. Moe, Jonathan G. Howlett, Lawrence J. Fine, John A. Spertus, Timothy R. McConnell, Ileana L. Piña, Kevin P. Weinfurt

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

Background: Heart failure trials use a variety of measures of functional capacity and quality of life. Lack of formal assessments of the relationships between changes in multiple aspects of patient-reported health status and measures of functional capacity over time limits the ability to compare results across studies. Methods: Using data from HF-ACTION (N = 2331), we used the Pearson correlation coefficients and predicted change scores from linear mixed-effects modeling to demonstrate the associations between changes in patient-reported health status measured with the EQ-5D visual analog scale and the Kansas City Cardiomyopathy Questionnaire (KCCQ) and changes in peak VO 2 and 6-minute walk distance at 3 and 12 months. We examined a 5-point change in KCCQ within individuals to provide a framework for interpreting changes in these measures. Results: After adjustment for baseline characteristics, correlations between changes in the visual analog scale and changes in peak VO2 and 6-minute walk distance ranged from 0.13 to 0.28, and correlations between changes in the KCCQ overall and subscale scores and changes in peak VO2 and 6-minute walk distance ranged from 0.18 to 0.34. A 5-point change in KCCQ was associated with a 2.50-mL kg-1 min-1 change in peak VO2 (95% CI 2.21-2.86) and a 112-m change in 6-minute walk distance (95% CI 96-134). Conclusions: Changes in patient-reported health status are not highly correlated with changes in functional capacity. Our findings generally support the current practice of considering a 5-point change in the KCCQ within individuals to be clinically meaningful.

Original languageEnglish (US)
Pages (from-to)88-94.e3
JournalAmerican heart journal
Volume163
Issue number1
DOIs
StatePublished - Jan 2012

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Flynn, K. E., Lin, L., Moe, G. W., Howlett, J. G., Fine, L. J., Spertus, J. A., McConnell, T. R., Piña, I. L., & Weinfurt, K. P. (2012). Relationships between changes in patient-reported health status and functional capacity in outpatients with heart failure. American heart journal, 163(1), 88-94.e3. https://doi.org/10.1016/j.ahj.2011.09.027