Quality of life in patients with chronic heart failure in multi-ethnic urban population

Background: Currently, The prevalence of heart failure (HF) is increasing, further studies are required to compare the quality of life (QOL) amongst diverse groups of patients with HF classified regarding ejection fraction (EF) according to the European society of cardiology (ESC) HF guidelines into either patients with reduced ejection fraction (HFrEF), mid-range EF (HFmrEF) or preserved EF (HFpEF) in Saudi Arabia managed with guideline directed medical therapy (GDMT) in heart function clinics (HFCs). Objectives: The aim of this paper is to review information on QOL in patients with HF. Methods: 420 patients responded to the QOL Minnesota Living with Heart Failure Questionnaire (MLHFQ) were classified into three group according to their ejection fraction less than 40%, from 40 to 49% and more than or equal 50%. The estimated QOL scores were classified according to cutoffs < 24 represents a good QOL, a score between 24 and 45 represents an intermediate QOL, and a score > 45 represents a poor QoL Results: Participants had a mean age of 59 +/- 15, 38% were women, 85% were Saudi nationality, 17% were smoking, 63% were diabetic, 73 % were hypertensive, 47% were anemic, 30% were with renal impairment, 11% were hypothyroid, 4% had history of cerebrovascular stroke, 3% were with chronic obstructive pulmonary disease (COPD), history of malignancies were in 3%. The QOL for the whole cohort had a mean of 31, median of 27 with minimum of 0 and maximum of 87 +/- 20. QOL score found to be good (less than 24) in 44%, intermediate (ranging from 24-45) in 33%, and poor (more than 45) in 23 %. According to the ESC heart failure guideline classifications of HF subgroups, there were no statistically significant differences regarding QOL patients followed in HFCs whether HfrEF (EF less than 40%), HFmrEF (EF from 40-49%) or HFpEF (EF more than or equal 50%). Conclusion: No statistically significant differences regarding quality of life in HF patients followed in HFCs irrespective of their EF either HFrEF, HFmrEF or HfpEF groups. In spite of, therapeutic advances in management of HFrEF their QOL still inferior with no statistically significant difference when compared to HFpEF patients whom well-defined therapy is still lacking.