+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Variability in the clinical status of patients with advanced heart failure



Variability in the clinical status of patients with advanced heart failure



Journal of Cardiac Failure 10(5): 397-402



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. 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. 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.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 050932006

Download citation: RISBibTeXText

PMID: 15470650

DOI: 10.1016/j.cardfail.2003.12.008


Related references

Heart rate variability monitored by the implanted device predicts response to CRT and long-term clinical outcome in patients with advanced heart failure. European Journal of Heart Failure 10(11): 1073-1079, 2008

Atorvastatin therapy increases heart rate variability, decreases QT variability, and shortens QTc interval duration in patients with advanced chronic heart failure. Journal of Cardiac Failure 11(9): 684-690, 2005

Relationship of plasma galectin-3 to renal function in patients with heart failure: effects of clinical status, pathophysiology of heart failure, and presence or absence of heart failure. Journal of the American Heart Association 1(5): E000760, 2012

Impact of a comprehensive heart failure management program on hospital readmission and functional status of patients with advanced heart failure. Journal Of The American College Of Cardiology. 30(3): 725-732, 1997

Impact of a specialized outpatient heart failure follow-up program on hospitalization frequency and functional status of patients with advanced heart failure. Revista Portuguesa de Cardiologia 26(4): 335-343, 2007

Heart failure severity does not predict employment status in advanced heart failure patients. Circulation 104(17 Suppl.): II 723-II 724, 2001

Relationship of heart rate variability to sudden death in advanced heart failure patients. Circulation 88(4 Part 2): I14, 1993

Complex heart rate variability and serum norepinephrine levels in patients with advanced heart failure. Journal Of The American College Of Cardiology. 23(3): 565-569, 1994

Ability of heart rate variability to predict prognosis in patients with advanced congestive heart failure. American Journal of Cardiology 80(6): 808-811, 1997

Comparison of short-term to 24-hour measures of heart rate variability in advanced heart failure patients. Circulation 100(18 Suppl. ): I 738, 1999

Relation between heart rate variability and electrical vulnerability to ventricular tachyarrhythmias in patients with advanced heart failure. European Heart Journal 22(Abstract Suppl.): 439, 2001

The impact of positive airway pressure on cardiac status and clinical outcomes in patients with advanced heart failure and sleep-disordered breathing: a preliminary report. Sleep & Breathing 15(4): 701-709, 2012

Autonomic nervous system in heart failure: an endless area of research/ The preserved autonomic functions may provide the asymptomatic clinical status in heart failure despite advanced left ventricular systolic dysfunction. Anadolu Kardiyoloji Dergisi 11(4): 373; Author Reply 373-4, 2011

Heart rate variability in mild to moderate heart failure Correlations with neurohumoral status and clinical parameters. Journal of the Autonomic Nervous System 43(Suppl. ): 63, 1993

The prognostic use of right heart catheterization data in patients with advanced heart failure: how relevant are invasive procedures in the risk stratification of advanced heart failure in the era of neurohormones?. Journal of Heart and Lung Transplantation 24(3): 303-309, 2005