Variability in the clinical status of patients with advanced heart failure

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

Research output: Contribution to journalArticle

30 Scopus citations

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

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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., 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