Abstract 2287: Clinical/Neurohormonal Correlates and Prognostic Value of Kansas City Cardiomyopathy Questionnaire in Patients With Chronic Heart Failure
Background: Chronic heart failure (CHF) is characterized by limited exercise activity and increased morbidity and mortality. Although quality of life and physical activity assessed by Kansas City Cardiomyopathy Questionnaire (KCCQ functional and overall) have been used for the clinical evaluation of CHF patients, the relationship of this questionairre with CHF neurohormonal activation as well as its prognostic value remain uknown.
Methods: Seventy five consecutive stable CHF patients (aged 65 ± 13 yrs, mean NYHA class:2.9 ± 0.6, left ventricular ejection fraction <40%) were evaluated by the above questionnaire, Zung Self-rating Depression Scale (SDS), Beck Depression Inventory (BDI) scale, Duke Activity Status Index (DASI), plasma BNP and 6-min walking test. Patients were monitored for a 10-month follow-up period for disease progression defined as death and/or hospitalization.
Results: The mean KCCQ functional and overall scores were 47.3±19.4% and 35.6±19.0%, respectively. Patients (n=20) with KCCQ overall score <50% had significantly higher Zung SDS (45±9 vs 36±10, p<0.01), BDI (19±9 vs 6±3, p<0.01), and plasma BNP (1078±900 vs 492±301 pg/ml, p<0.05) as well as lower DASI (15±10 vs 28±13, p<0.01) and 6-min walking distance (253±123 vs 357±108 m, p<0.05) as compared to those with score >50% (n=55). KCCQ overall score was significantly corellated with plasma BNP levels (r=−0.42, p<0.01), 6-min walking distance (r=0.47, p<0.01) and BDI (r=−0.61, p<0.001). Finally, patients with KCCQ overall score >50% had longer event-free survival than those with score >50% (205±20 vs 135±16 days, log-rank p=0.0399).
Conclusion: KCCQ is a valuable tool for the evaluation of severity of clinical and emotional symptoms of CHF patients, reflecting also increased neurohormonal activation and having important prognostic value in CHF.