Anemia is common in patients with chronic heart failure (HF), with a prevalence ranging from 10% to 56%, and may be a risk factor for poor outcomes. Anemia in HF remains poorly understood, with significant gaps in its impact on health-related quality of life (HRQoL), with most studies in HF being retrospective or from registries. The purpose of this study was to explore the relation of hemoglobin (Hgb) with HRQoL and training-induced changes in HRQoL in a cohort of patients in Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training (HF-ACTION). Using data from HF-ACTION, a randomized controlled trial of exercise training in patients with HF and low left ventricular ejection fractions, HRQoL was measured using the Kansas City Cardiomyopathy Questionnaire (KCCQ) at baseline, 3 and 12 months, and annually up to 4 years. Treatment group effects on HRQoL were estimated using linear mixed models according to the intention-to-treat principle. It was hypothesized that baseline Hgb would be correlated with baseline KCCQ scales and that Hgb would moderate the beneficial effect of exercise training on HRQoL. Hgb level was not significantly correlated with baseline HRQoL. Baseline Hgb did not moderate the beneficial effect of exercise training on KCCQ overall or subscales relative to usual care. In conclusion, in the HF-ACTION cohort, there was no correlation with baseline Hgb and baseline HRQoL as measured by the KCCQ. In addition, the beneficial effects of HRQoL from exercise training were not modulated by baseline Hgb.

译文

:贫血在慢性心力衰竭(HF)患者中很常见,患病率从10%到56%不等,并且可能是不良预后的危险因素。 HF的贫血仍然知之甚少,它对健康相关的生活质量(HRQoL)的影响还存在很大差距,大多数HF的研究都是回顾性研究或来自注册机构。本研究的目的是探讨心力衰竭患者队列中血红蛋白(Hgb)与HRQoL和训练诱发的HRQoL变化的关系:运动训练(HF-ACTION)的对照研究结果。使用来自HF-ACTION的数据,这是一项针对HF和左心室射血分数低的患者进行的运动训练的随机对照试验,使用堪萨斯城心肌病问卷(KCCQ)在基线,3个月和12个月以及每年最多4个月测量HRQoL年。根据意向性治疗原则,使用线性混合模型评估治疗组对HRQoL的影响。假设基线Hgb与基线KCCQ量表相关,并且Hgb会减轻运动训练对HRQoL的有益作用。 Hgb水平与基线HRQoL没有显着相关。基线Hgb并未减轻运动训练对KCCQ整体或相对于常规护理的分量表的有益作用。总之,在HF-ACTION队列中,通过KCCQ测量的与基线Hgb和基线HRQoL没有相关性。此外,运动训练对HRQoL的有益作用并未受到基线Hgb的调节。

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