Skip Navigation

European Journal of Heart Failure 2009 11(2):163-169; doi:10.1093/eurjhf/hfn032
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Parissis, J. T.
Right arrow Articles by Kremastinos, D. T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Parissis, J. T.
Right arrow Articles by Kremastinos, D. T.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

Self-assessment of health status is associated with inflammatory activation and predicts long-term outcomes in chronic heart failure

John T. Parissis*, Maria Nikolaou, Dimitrios Farmakis, Ioannis A. Paraskevaidis, Vassiliki Bistola, Koula Venetsanou, Dimitrios Katsaras, Gerasimos Filippatos and Dimitrios T. Kremastinos

Heart Failure Clinic, Second Department of Cardiology, Attikon University Hospital, Navarinou 13, Maroussi, 15122 Athens, Greece

* Corresponding author. Tel: +30 210 6123720, Fax: +30 210 5832195, Email: jparissis{at}yahoo.com


  Abstract

Aims: Clinicians lack a generally accepted means for health status assessment in chronic heart failure (CHF). We investigated the correlation between health status and inflammation burden as well as its long-term prognostic value in CHF outpatients.

Methods and Results: Kansas City Cardiomyopathy Questionnaires (KCCQ) were completed by 137 CHF outpatients (aged 64 ± 12 years, mean ejection fraction 27 ± 7%). Inflammatory markers [interleukin (IL)-6, IL-10, TNF-{alpha}, soluble Fas, Fas ligand, ICAM-1, VCAM-1], plasma B-type natriuretic peptide (BNP), 6 min walk test (6MWT), Zung self-rating depression scale, and Beck Depression Inventory were also assessed. Patients were followed for major cardiovascular events (death or hospitalization for disease progression) for up to 250 days. Patients with worse KCCQ-summary (KCCQ-s < 50) score had lower 6MWT (P < 0.05), and higher BNP (P < 0.05) and pro-inflammatory markers (P < 0.05) than those with KCCQ-s ≥ 50. Worse health status was also associated with shorter event-free survival (115 ± 12 days for KCCQ-s < 50 vs. 214 ± 15 days for KCCQ-s ≥ 50, P = 0.0179). Separating patients according KCCQ-functional score (KCCQ-f, cut-off 50) showed similar results. In multivariate Cox regression analysis, only LVEF (HR = 0.637, 95% CI 0.450–0.900, P = 0.011) and KCCQ-f (HR = 0.035, 95% CI 0.002–0.824, P = 0.037) were independent predictors of event-free survival at 250 days.

Conclusion: KCCQ-s reflects neurohormonal and inflammatory burden in CHF. Among studied questionnaires, only KCCQ-f is an independent predictor of long-term event-free survival in CHF.

Key Words: Health status • Depression • Kansas City Cardiomyopathy Questionnaire • Minnesota Living with Heart Failure Questionnaire • Heart failure • Cytokines • Prognosis

Received May 30, 2008; Revised August 12, 2008; Accepted November 17, 2008


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.