Patient-Reported Outcomes in Heart Failure Management
Summary
Patient‐reported outcomes (PROs) have become central to the holistic management of heart failure, providing insights into symptoms, functional capacity and health‐related quality of life (HRQoL) that complement traditional clinical measures. Monitoring tools such as the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the Euro-QoL-5D visual analogue scale (EQ-5D-VAS) enable longitudinal tracking of symptoms, physical limitations and psychosocial burden directly from the patient perspective. Serial assessment of HRQoL has been shown to predict hospital admissions and mortality across heart failure subtypes, including reduced (HFrEF), mildly reduced (HFmrEF) and preserved ejection fraction (HFpEF). Integration of PROs into routine care supports shared decision making, guides treatment adjustments and informs prognostication. The global standardisation of outcome sets has facilitated benchmarking of care pathways and underlined the importance of culturally appropriate measurement tools. Recent advances in pharmacotherapy and digital monitoring highlight both improvements in patient‐reported health status and the need for responsive, validated instruments to capture clinically meaningful change.
Research from Nature Portfolio
Recent trials have demonstrated that sodium‐glucose cotransporter 2 (SGLT2) inhibition with dapagliflozin in patients with HFpEF leads to significant improvements in patient‐reported health status. Treatment was associated with clinically meaningful increases in KCCQ clinical summary scores, overall symptom burden reduction and enhanced physical limitation domains over a 12-week period. Improvements in exercise capacity as measured by the six-minute walk test were observed alongside favourable effects on weight and biomarkers, indicating that PRO measures can sensitively capture the benefits of targeted cardiometabolic therapy in chronic heart failure.
Patient-Reported Outcomes in Heart Failure Management publication trend
The graph below shows the total number of articles in patient-reported outcomes in heart failure management across all publications each year (not limited to Nature Index journals).
Technical terms
Patient‐reported outcome (PRO): Information on health status directly reported by the patient without interpretation by clinicians or others.
Health‐related quality of life (HRQoL): A multidimensional concept encompassing physical, psychological and social domains of health as perceived by the patient.
Kansas City Cardiomyopathy Questionnaire (KCCQ): A validated heart failure–specific instrument measuring symptoms, physical function and quality of life.
Euro-QoL-5D visual analogue scale (EQ-5D-VAS): A generic measure of self‐rated health on a 0–100 scale.
Heart failure with preserved/reduced ejection fraction (HFpEF/HFrEF): Classification of heart failure based on left ventricular ejection fraction above or below predefined thresholds.
SGLT2 inhibitor: A class of medications reducing glucose reabsorption in the kidney, emerging as modulators of cardiovascular outcomes in heart failure.
References
- Changing health related quality of life and outcomes in heart failure by age, sex and subtype. EClinicalMedicine (2023).
- Dapagliflozin and Physical and Social Activity Limitations in Heart Failure With Reduced Ejection Fraction. JACC Heart Failure (2023).
- The SGLT2 inhibitor dapagliflozin in heart failure with preserved ejection fraction: a multicenter randomized trial. Nature Medicine (2021).
- International Consortium for Health Outcomes Measurement (ICHOM): Standardized Patient-Centered Outcomes Measurement Set for Heart Failure Patients. JACC Heart Failure (2019).
- Effects of Empagliflozin on Symptoms, Physical Limitations, and Quality of Life in Patients Hospitalized for Acute Heart Failure: Results From the EMPULSE Trial. Circulation (2022).
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