Synergistic Effect of Disease Severity, Anxiety Symptoms and Elderly Age on the Quality of Life of Outpatients with Heart Failure
José Henrique Cunha Figueiredo
Gláucia Maria Moraes de Oliveira
Basílio Bragança Pereira
Ana Elisa Bastos Figueiredo
Emília Matos Nascimento
Marcelo Iorio Garcia
Sergio Salles Xavier
Background: Heart failure (HF) is a multifactorial syndrome with repercussions on quality of life (QoL).
Objectives: To investigate the main interacting factors responsible to worsen quality of life of outpatients with HF.
Methods: Cross-sectional observational study with 99 patients of both genders, attending a HF outpatient clinic at a university hospital, all with a reduced ejection fraction (< 0.05 and 0.05 < p < 0.10 for statistical and clinical significance, respectively.
Results: Beta regression showed that depression and anxiety symptoms worsened the QoL of HF patients, as well as male sex, age younger than 60 years old, lower education level, lower monthly family income, recurrent hospitalizations and comorbidities such as ischemic heart diseases and arterial hypertension. The regression tree confirmed that NYHA functional class III and IV worsen all dimensions of MLwHF by interacting with anxiety symptoms, which influenced directly or indirectly the presence of poorer total score and emotional dimension of MLwHF. Previous hospitalization in the emotional dimension and age younger than 60 years in general dimension were associated with anxiety and NYHA functional class, also worsening the QoL of HF patients.
Conclusion: HF with reduced ejection fraction was associated with poorer MLwHF. Anxiety symptoms, previous hospitalization and younger age were also associated with worsened MLwHF. Knowledge of these risk factors can therefore guide assessment and treatment of HF patients. (Arq Bras Cardiol. 2020; 114(1):25-32)
Keywords: Heart Failure; Anxiety/diagnosis; Hospitalization; Quality of Life; Age; Systolic Volume