Author + information
- Received August 1, 2017
- Revision received February 15, 2018
- Accepted February 18, 2018
- Published online June 25, 2018.
- Rebecca Napier, MDa,
- Steven E. McNulty, MSb,
- David T. Eton, PhDc,
- Margaret M. Redfield, MDa,
- Omar AbouEzzeddine, MD, CM, MSa and
- Shannon M. Dunlay, MD, MSa,c,∗ ()
- aDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
- bDuke Clinical Research Institute, Durham, North Carolina
- cDepartment of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
- ↵∗Address for correspondence:
Dr. Shannon M. Dunlay, Mayo Clinic, 200 First Street Southwest, Rochester, Minnesota 55905.
Objectives This study sought to compare the performance of 2 health-related quality of life (HRQOL) questionnaires in patients with heart failure with preserved ejection fraction (HFpEF).
Background The ability to accurately assess HRQOL over time is important in the care of patients with heart failure. The validity and reliability of HRQOL tools including the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and the Kansas City Cardiomyopathy Questionnaire (KCCQ) has not been fully determined or compared in patients with HFpEF.
Methods Among patients with stable chronic HFpEF enrolled in the NEAT (Nitrate Effect on Activity Tolerance in Heart Failure) trial (n = 110), the study evaluated and compared reliability, validity, and responsiveness to change of the MLHFQ and KCCQ at baseline, 6 weeks, and 12 weeks.
Results Internal consistency was good and comparable for MLHFQ and KCCQ domains measuring similar aspects of HRQOL at baseline including the MLHFQ physical (Cronbach’s α = 0.93) compared with the KCCQ clinical summary (α = 0.91), and the MLHFQ emotional (α = 0.92) compared with the KCCQ quality of life (α = 0.87). Correlations with New York Heart Association functional class (Spearman rho; rs= −0.37 vs. 0.30) and 6-min walk test (6MWT) (rs = 0.38 vs. −0.23) at baseline were slightly stronger for the KCCQ overall summary score than for the MLHFQ total score. The MLHFQ was more responsive to change in 6MWT based on responsiveness statistics.
Conclusions These data suggest that both the MLHFQ and KCCQ are reliable and valid tools to assess HRQOL in HFpEF. The KCCQ was more strongly correlated with baseline functional status parameters, while the MLHFQ was more responsive to improvement in 6MWT.
This research was supported by grant numbers U10 HL084904 (awarded to the coordinating center) and U01 HL084861, U10HL110312, U10 HL110337, U10 HL110342, U10 HL110262, U10 HL110297, U10 HL110302, U10 HL110309, U10 HL110336, and U10 HL110338 (awarded to the regional clinical centers) from the National Heart, Lung, and Blood Institute. Dr. Dunlay’s time is funded by the National Institutes of Health (K23 HL 116643). The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received August 1, 2017.
- Revision received February 15, 2018.
- Accepted February 18, 2018.
- 2018 American College of Cardiology Foundation