Variability in the clinical status of patients with advanced heart failure

Paul J. Hauptman, Frederick A. Masoudi, William S. Weintraub, Ileana L. Pina, Philip G. Jones, John A. Spertus

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background: The importance of repeated clinical assessments of patients with heart failure is widely accepted. The frequency of such follow-up is not established and is likely to depend on the natural history and variability of patients' health status and the availability and use of appropriate treatments. Methods and Results: We analyzed data from a multicenter prospective cohort study of heart failure outpatients comparing baseline variables including New York Heart Association (NYHA) class, summary score on the Kansas City Cardiomyopathy Questionnaire (KCCQ), and performance on a 6-minute walk test with results of a repeat evaluation at 6 weeks. We also compared patient and physician assessment of change in disease status among patients with advanced symptoms (NYHA class III with a recent antecedent hospitalization or class IV) and those with milder degrees of limitation (NYHA classes I, II, and stable III). Patients with advanced symptoms had greater short-term variability in health status as reflected by the KCCQ summary score and a visual analog scale. A greater proportion of patients with advanced heart failure experienced moderate or greater clinical change. Patient and physician global assessments were congruent with more direct measures of health status. Conclusion: Patients with advanced heart failure have greater short-term variability in status, supporting the need for frequent clinical follow-up and appropriate power calculations for clinical trials that are designed to measure meaningful changes over a short period.

Original languageEnglish (US)
Pages (from-to)397-402
Number of pages6
JournalJournal of Cardiac Failure
Volume10
Issue number5
DOIs
StatePublished - Oct 2004
Externally publishedYes

Fingerprint

Heart Failure
Health Status
Cardiomyopathies
Physicians
Natural History
Visual Analog Scale
Hospitalization
Cohort Studies
Outpatients
Clinical Trials
Prospective Studies

Keywords

  • Heart failure
  • Quality of life

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Hauptman, P. J., Masoudi, F. A., Weintraub, W. S., Pina, I. L., Jones, P. G., & Spertus, J. A. (2004). Variability in the clinical status of patients with advanced heart failure. Journal of Cardiac Failure, 10(5), 397-402. https://doi.org/10.1016/j.cardfail.2003.12.008

Variability in the clinical status of patients with advanced heart failure. / Hauptman, Paul J.; Masoudi, Frederick A.; Weintraub, William S.; Pina, Ileana L.; Jones, Philip G.; Spertus, John A.

In: Journal of Cardiac Failure, Vol. 10, No. 5, 10.2004, p. 397-402.

Research output: Contribution to journalArticle

Hauptman, PJ, Masoudi, FA, Weintraub, WS, Pina, IL, Jones, PG & Spertus, JA 2004, 'Variability in the clinical status of patients with advanced heart failure', Journal of Cardiac Failure, vol. 10, no. 5, pp. 397-402. https://doi.org/10.1016/j.cardfail.2003.12.008
Hauptman PJ, Masoudi FA, Weintraub WS, Pina IL, Jones PG, Spertus JA. Variability in the clinical status of patients with advanced heart failure. Journal of Cardiac Failure. 2004 Oct;10(5):397-402. https://doi.org/10.1016/j.cardfail.2003.12.008
Hauptman, Paul J. ; Masoudi, Frederick A. ; Weintraub, William S. ; Pina, Ileana L. ; Jones, Philip G. ; Spertus, John A. / Variability in the clinical status of patients with advanced heart failure. In: Journal of Cardiac Failure. 2004 ; Vol. 10, No. 5. pp. 397-402.
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