Quality of life score association with other patient-reported outcomes

Abstract

Introduction and objectives: Pragmatic validated instruments are needed to assess quality of life (QoL) in the real-world care of heart failure (HF) patients. This study aimed to validate the Minnesota Living with Heart Failure Questionnaire (MLHFQ) in European Portuguese and to search for associations with other patient-reported outcomes (PROs). Methods: This is a single-center prospective study with two samples of HF patients, used for MLHFQ translation, cultural adaptation and validation. Validation sample included patients managed in a multidisciplinary HF clinic between February 29, 2016, and February 29, 2020. Results: The validation sample included 294 HF patients, with a median age of 78 years, 53.1% female sex, 45.2% with reduced left ventricle ejection fraction (LVEF) and 43.9% with preserved LVEF. The principal component analysis identified three components, representing three groups of questions from the MLHFQ, each related to one domain and subscore: physical, emotional and social. The validated version showed a reliable general factor and good internal consistency. MLHFQ total score was associated with all the other variables studied. All the scores were strongly associated with NYHA functional class. Associations were found between the physical score and both the Borg fatigue score and the six-minute walking distance. Emotional score was associated with both anxiety and depression scores from Hospital Anxiety and Depression Scale. Conclusions: This study validated the MLHFQ in Portuguese and revealed the existence of three subscores. It enables the pragmatic assessment of the QoL of Portuguese HF patients, particularly of those with preserved LVEF, and future research concerning PROs.