Clinical InvestigationCongestive Heart FailureMonitoring clinical changes in patients with heart failure: A comparison of methods
Section snippets
Study population
Patients were recruited through the Cardiovascular Outcomes Research Consortium, a collaborative of 14 North American centers (Appendix). Outpatients with the diagnosis of heart failure in their outpatient medical record, or a hospitalization for decompensated heart failure within the past 3 years, were screened for participation. Patients with documented left ventricular systolic dysfunction (left ventricular ejection fraction <0.40) and who were >30 years of age were asked to participate and
Patient population
A total of 547 patients were enrolled in the study; complete 6-week follow-up data were available on 476 (87%). There were 5 deaths during the study. Baseline demographic, clinical, and health status characteristics of the study population are summarized in Table II. Of 120 baseline demographic, clinical, and health status variables collected, only a few differed significantly between those with and without follow-up. Those without follow-up were less likely to be white (57% vs 70%, P = .04),
Discussion
This study compared the ability of multiple different measures to monitor the clinical status of patients with heart failure over time. We compared the sensitivity of several health status questionnaires (the KCCQ, SF-12, and the EQ-5D), a physician-assessed measure of patient function (the NYHA), a physiological test of exercise capacity (6-minute walk test), patient weight, and a biomarker of disease severity (BNP) to reflect clinical change over 6 weeks in a multicenter cohort of outpatients
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