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Quality of Life Research

, Volume 21, Issue 7, pp 1171–1176 | Cite as

Impact of diabetes mellitus on quality of life in patients with congestive heart failure

  • Buntaro Fujita
  • Alexander Lauten
  • Bjoern Goebel
  • Marcus Franz
  • Michael Fritzenwanger
  • Markus Ferrari
  • Hans R. Figulla
  • Friedhelm Kuethe
  • Christian Jung
Article

Abstract

Objectives

Congestive heart failure (CHF) and diabetes mellitus (DM) are increasing in prevalence. There are conflicting data regarding the crosstalk of DM and CHF with respect to the prognostic impact for the patients. Health-related quality of life (Hr-QoL) has been reported to be useful for risk stratification. The purpose of this study was to investigate the impact of DM on Hr-QoL in a CHF population.

Methods

325 consecutive patients with CHF were retrospectively analyzed (age 49 ± 12 years, 74.2% male, 18% had diabetes). After a median follow-up time of 7.4 years, we compared Hr-QoL of patients with and without DM. Hr-QoL was assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Kaplan–Meier curves were used to compare survival.

Results

The presence of DM reduced Hr-QoL in patients with CHF, indicated by a higher overall MLHFQ score (43.5 vs. 21, P = 0.013). Kaplan–Meier survival curves showed a significant survival difference (P = 0.024). Survival rates of both groups differed significantly after 3 (P = 0.031), 5 (P = 0.006), and 10 years (P = 0.047) favoring the group without DM.

Conclusions

In patients with CHF, the coexistence of DM is associated with a reduced Hr-QoL and a particularly poor long-term survival. Our results indicate that CHF patients with DM are at increased risk.

Keywords

Heart failure Diabetes mellitus Minnesota Follow-up Quality of life 

Notes

Conflict of interest

None.

Supplementary material

11136_2011_39_MOESM1_ESM.doc (46 kb)
Supplementary material 1 (DOC 45 kb)

References

  1. 1.
    Fang, J., Mensah, G. A., Croft, J. B., & Keenan, N. L. (2008). Heart failure-related hospitalization in the U.S., 1979 to 2004. Journal of the American College of Cardiology, 52(6), 428–434.PubMedCrossRefGoogle Scholar
  2. 2.
    WRITING GROUP MEMBERS, Lloyd-Jones, D., Adams, R. J., Brown, T. M., Carnethon, M., Dai, S., De Simone, G., Ferguson, T. B., Ford, E., Furie, K., Gillespie, C., Go, A., Greenlund, K., Haase, N., Hailpern, S., Ho, P. M., Howard, V., Kissela, B., Kittner, S., Lackland, D., Lisabeth, L., Marelli, A., McDermott, M. M., Meigs, J., Mozaffarian, D., Mussolino, M., Nichol, G., Roger, V. L., Rosamond, W., Sacco, R., Sorlie, P., Stafford, R., Thom, T., Wasserthiel-Smoller, S., Wong, N. D., Wylie-Rosett, J., Committee, on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Executive Summary: Heart Disease and Stroke Statistics–2010 Update: A Report From the American Heart Association. Circulation, 121(7), 948–954.Google Scholar
  3. 3.
    Jessup, M., Abraham, W. T., Casey, D. E., Feldman, A. M., Francis, G. S., Ganiats, T. G., Konstam, M. A., Mancini, D. M., Rahko, P. S., Silver, M. A., Stevenson, L. W., & Yancy, C. W. (2009). 2009 Focused Update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: Developed in Collaboration With the International Society for Heart and Lung Transplantation. Circulation, 119(14), 1977–2016.Google Scholar
  4. 4.
    Krumholz, H. M., Peterson, E. D., Ayanian, J. Z., Chin, M. H., DeBusk, R. F., Goldman, L., et al. (2005). Report of the national heart, lung, and blood institute working group on outcomes research in cardiovascular disease. Circulation, 111(23), 3158–3166.PubMedCrossRefGoogle Scholar
  5. 5.
    Mommersteeg, P. M. C., Denollet, J., Spertus, J. A., & Pedersen, S. S. (2009). Health status as a risk factor in cardiovascular disease: A systematic review of current evidence. American Heart Journal, 157(2), 208–218.PubMedCrossRefGoogle Scholar
  6. 6.
    Bekelman, D. B., Havranek, E. P., Becker, D. M., Kutner, J. S., Peterson, P. N., Wittstein, I. S., et al. (2007). Symptoms, depression, and quality of life in patients with heart failure. Journal of Cardiac Failure, 13(8), 643–648.PubMedCrossRefGoogle Scholar
  7. 7.
    Rector, T. S., Anand, I. S., & Cohn, J. N. (2006). Relationships between clinical assessments and patients’ perceptions of the effects of heart failure on their quality of life. Journal of Cardiac Failure, 12(2), 87–92.PubMedCrossRefGoogle Scholar
  8. 8.
    Hallas, C. N., Wray, J., Andreou, P., & Banner, N. R. (2011). Depression and perceptions about heart failure predict quality of life in patients with advanced heart failure. Heart & Lung: The Journal of Acute and Critical Care, 40(2), 111–121.CrossRefGoogle Scholar
  9. 9.
    Evangelista, L. S., Moser, D. K., Westlake, C., Hamilton, M. A., Fonarow, G. C., & Dracup, K. (2006). Impact of obesity on quality of life and depression in patients with heart failure. European Journal of Heart Failure, 8(7), 750–755.PubMedCrossRefGoogle Scholar
  10. 10.
    Kato, N., Kinugawa, K., Seki, S., Shiga, T., Hatano, M., Yao, A., et al. (2011). Quality of life as an independent predictor for cardiac events and death in patients with heart failure. Circulation Journal, 75(7), 1661–1669.PubMedCrossRefGoogle Scholar
  11. 11.
    Cohen-Solal, A., Beauvais, F., & Logeart, D. (2008). Heart failure and diabetes mellitus: Epidemiology and management of an alarming association. Journal of Cardiac Failure, 14(7), 615–625.PubMedCrossRefGoogle Scholar
  12. 12.
    From, A. M., Leibson, C. L., Bursi, F., Redfield, M. M., Weston, S. A., Jacobsen, S. J., et al. (2006). Diabetes in heart failure: Prevalence and impact on outcome in the population. The American Journal of Medicine, 119(7), 591–599.PubMedCrossRefGoogle Scholar
  13. 13.
    Adams, J. K. F., Fonarow, G. C., Emerman, C. L., LeJemtel, T. H., Costanzo, M. R., Abraham, W. T., et al. (2005). Characteristics and outcomes of patients hospitalized for heart failure in the United States: Rationale, design, and preliminary observations from the first 100, 000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE). American Heart Journal, 149(2), 209–216.PubMedCrossRefGoogle Scholar
  14. 14.
    Kamalesh, M., & Nair, G. (2005). Disproportionate increase in prevalence of diabetes among patients with congestive heart failure due to systolic dysfunction. International Journal of Cardiology, 99(1), 125–127.PubMedCrossRefGoogle Scholar
  15. 15.
    American Diabetes Association (2006). Diagnosis and Classification of Diabetes Mellitus. Diabetes Care, 29(Suppl 1), s43–s48.Google Scholar
  16. 16.
    Garin, O., Ferrer, M., Pont, À., Rué, M., Kotzeva, A., Wiklund, I., et al. (2009). Disease-specific health-related quality of life questionnaires for heart failure: A systematic review with meta-analyses. Quality of Life Research, 18(1), 71–85.PubMedCrossRefGoogle Scholar
  17. 17.
    Morgan, K., McGee, H., & Shelley, E. (2007). Quality of life assessment in heart failure interventions: a 10-year (1996–2005) review. European Journal of Cardiovascular Prevention & Rehabilitation, 14(5), 589–607. doi: 510.1097/HJR.1090b1013e32828622c32828623.CrossRefGoogle Scholar
  18. 18.
    Bennett, S. J., Oldridge, N. B., Eckert, G. J., Embree, J. L., Browning, S., Hou, N., et al. (2002). Discriminant properties of commonly used quality of life measures in heart failure. Quality of Life Research, 11(4), 349–359.CrossRefGoogle Scholar
  19. 19.
    Reiss, N., Kleikamp, G., Tenderich, G., Tschöpe, D., & Körfer, R. (2008). Diabetes mellitus und Herzinsuffizienz–Inzidenz und chirurgische Therapieoptionen. Herz, 33(3), 206–210.PubMedCrossRefGoogle Scholar
  20. 20.
    Ruo, B., Rumsfeld, J. S., Hlatky, M. A., Liu, H., Browner, W. S., & Whooley, M. A. (2003). Depressive symptoms and health-related quality of life. JAMA: The Journal of the American Medical Association, 290(2), 215–221.CrossRefGoogle Scholar
  21. 21.
    Alla, F., Briançon, S., Guillemin, F., Juillière, Y., Mertès, P.-M., Villemot, J.-P., et al. (2002). Self-rating of quality of life provides additional prognostic information in heart failure. Insights into the EPICAL study. European Journal of Heart Failure, 4(3), 337–343.PubMedCrossRefGoogle Scholar
  22. 22.
    Kosiborod, M., Soto, G. E., Jones, P. G., Krumholz, H. M., Weintraub, W. S., Deedwania, P., et al. (2007). Identifying heart failure patients at high risk for near-term cardiovascular events with serial health status assessments. Circulation, 115(15), 1975–1981.PubMedCrossRefGoogle Scholar
  23. 23.
    Jung, C., Rafnsson, A., Shemyakin, A., Böhm, F., & Pernow, J. (2010). Different subpopulations of endothelial progenitor cells and circulating apoptotic progenitor cells in patients with vascular disease and diabetes. International Journal of Cardiology, 143(3), 368–372.PubMedCrossRefGoogle Scholar
  24. 24.
    Hoekstra, T., Lesman-Leegte, I., van Veldhuisen, D. J., Sanderman, R., & Jaarsma, T. (2011). Quality of life is impaired similarly in heart failure patients with preserved and reduced ejection fraction. European Journal of Heart Failure, 13(9), 1013–1018.PubMedCrossRefGoogle Scholar
  25. 25.
    Lewis, E. F., Lamas, G. A., O’Meara, E., Granger, C. B., Dunlap, M. E., McKelvie, R. S., et al. (2007). Characterization of health-related quality of life in heart failure patients with preserved versus low ejection fraction in CHARM. European Journal of Heart Failure, 9(1), 83–91.PubMedCrossRefGoogle Scholar
  26. 26.
    Tsuchihashi-Makaya, M., Hamaguchi, S., Kinugawa, S., Yokota, T., Goto, D., Yokoshiki, H., et al. (2009). Characteristics and outcomes of hospitalized patients with heart failure and reduced vs preserved ejection fraction. A report from the japanese cardiac registry of heart failure in cardiology (JCARE-CARD). Circulation Journal, 73(10), 1893–1900.PubMedCrossRefGoogle Scholar
  27. 27.
    Packer, M., Colucci, W. S., Sackner-Bernstein, J. D., Liang, C.-s., Goldscher, D. A., Freeman, I., et al. (1996). Double-blind, placebo-controlled study of the effects of carvedilol in patients with moderate to severe heart failure: The precise trial. Circulation, 94(11), 2793–2799.PubMedCrossRefGoogle Scholar
  28. 28.
    Rogers, W., Johnstone, D., Yusuf, S., Weiner, D., Gallagher, P., Bittner, V., et al. (1994). Quality of life among 5,025 patients with left ventricular dysfunction randomized between placebo and enalapril: The studies of left ventricular dysfunction. The SOLVD Investigators. Journal of the American College of Cardiology, 23(2), 393–400.PubMedCrossRefGoogle Scholar
  29. 29.
    Mommersteeg, P. M. C., Kupper, N., Schoormans, D., Emons, W., & Pedersen, S. S. (2010). Health-related quality of life is related to cytokine levels at 12 months in patients with chronic heart failure. Brain, Behavior and Immunity, 24(4), 615–622.CrossRefGoogle Scholar
  30. 30.
    Parissis, J. T., Nikolaou, M., Farmakis, D., Paraskevaidis, I. A., Bistola, V., Venetsanou, K., et al. (2009). Self-assessment of health status is associated with inflammatory activation and predicts long-term outcomes in chronic heart failure. European Journal of Heart Failure, 11(2), 163–169.PubMedCrossRefGoogle Scholar
  31. 31.
    Farkas, J., Nabb, S., Zaletel-Kragelj, L., Cleland, J. G. F., & Lainscak, M. (2009). Self-rated health and mortality in patients with chronic heart failure. European Journal of Heart Failure, 11(5), 518–524.PubMedCrossRefGoogle Scholar
  32. 32.
    Subramanian, U., Eckert, G., Yeung, A., & Tierney, W. M. (2007). A single health status question had important prognostic value among outpatients with chronic heart failure. Journal of Clinical Epidemiology, 60(8), 803–811.PubMedCrossRefGoogle Scholar
  33. 33.
    Heo, S., Moser, D. K., Riegel, B., Hall, L. A., & Christman, N. (2005). Testing the psychometric properties of the Minnesota living with heart failure questionnaire. Nursing Research, 54(4), 265–272.PubMedCrossRefGoogle Scholar
  34. 34.
    Supino, P. G., Borer, J. S., Franciosa, J. A., Preibisz, J. J., Hochreiter, C., Isom, O. W., et al. (2009). Acceptability and psychometric properties of the Minnesota living with heart failure questionnaire among patients undergoing heart valve surgery: Validation and comparison with SF-36. Journal of Cardiac Failure, 15(3), 267–277.PubMedCrossRefGoogle Scholar
  35. 35.
    Adams, K. F., Jr, Sueta, C. A., Gheorghiade, M., O’Connor, C. M., Schwartz, T. A., Koch, G. G., et al. (1999). Gender differences in survival in advanced heart failure: Insights from the FIRST study. Circulation, 99(14), 1816–1821.PubMedCrossRefGoogle Scholar
  36. 36.
    Chin, M. H., & Goldman, L. (1998). Gender differences in 1-year survival and quality of life among patients admitted with congestive heart failure. Medical Care, 36(7), 1033–1046.PubMedCrossRefGoogle Scholar
  37. 37.
    Simon, T., Mary-Krause, M., Funck-Brentano, C., & Jaillon, P. (2001). Sex differences in the prognosis of congestive heart failure: Results from the cardiac insufficiency bisoprolol study (CIBIS II). Circulation, 103(3), 375–380.PubMedCrossRefGoogle Scholar
  38. 38.
    Varela-Roman, A., Shamagian, L. G., Caballero, E. B., Ramos, P. M., Veloso, P. R., & Gonzalez-Juanatey, J. R. (2005). Influence of diabetes on the survival of patients hospitalized with heart failure: A 12-year study. European Journal of Heart Failure, 7(5), 859–864.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Buntaro Fujita
    • 1
  • Alexander Lauten
    • 1
  • Bjoern Goebel
    • 1
  • Marcus Franz
    • 1
  • Michael Fritzenwanger
    • 1
  • Markus Ferrari
    • 1
  • Hans R. Figulla
    • 1
  • Friedhelm Kuethe
    • 1
  • Christian Jung
    • 1
  1. 1.Clinic of Internal Medicine IFriedrich-Schiller-UniversityJenaGermany

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