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Lebensqualität in einem Risikokollektiv für HFpEF: Einflussgrößen auf die Lebensqualiät und Assoziationen verschiedener Aspekte der Lebensqualität auf den klinischen Verlauf der Patienten - Ergebnisse der Diast-CHF-Studie -

dc.contributor.advisorEdelmann, Frank Prof. Dr.
dc.contributor.authorTaylor, Xenia Miriam Anna
dc.date.accessioned2021-07-28T12:51:22Z
dc.date.available2021-08-17T00:50:06Z
dc.date.issued2021-07-28
dc.identifier.urihttp://hdl.handle.net/21.11130/00-1735-0000-0008-58C8-4
dc.identifier.urihttp://dx.doi.org/10.53846/goediss-8724
dc.language.isodeude
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject.ddc610de
dc.titleLebensqualität in einem Risikokollektiv für HFpEF: Einflussgrößen auf die Lebensqualiät und Assoziationen verschiedener Aspekte der Lebensqualität auf den klinischen Verlauf der Patienten - Ergebnisse der Diast-CHF-Studie -de
dc.typedoctoralThesisde
dc.title.translatedQuality of life in a risk group for HFpEF: influencing factors on quality of life and association of different aspects of quality of life on the clinical outcome - Results of the Diast-CHF-study -de
dc.contributor.refereeEdelmann, Frank Prof. Dr.
dc.date.examination2021-08-10
dc.description.abstractengBackground: Heart failure with preserved ejection fraction (HFpEF) is relevant as the incidence and prevalence are constantly increasing. For a long time there were no standardized diagnostic criteria. In 2007 the ESC's HFA published a standardized diagnostic algorithm. Quality of life is an important part of the evaluation of therapy options. The quality of life is recorded using questionnaires. However, there has been no check to date as to whether there is an association between the diagnosis HFpEF and different components of quality of life. In addition to a detailed description of the quality of life of the risk population, it is interesting to see whether there is a connection between the quality of life and the clinical outcome of the patient. Methods: For the Diast CHF study, an observational multicenter study, patients with at least one risk factor for developing heart failure were recruited. At the time of the baseline, various examinations such as echocardiography were carried out. Furthermore, the test subjects have to fill out different questionnaires such as the SF-36 and the PHQ-D. Results: The test results are completely available for 1337 patients. Various scientific studies were able to prove that gender has an influence on the assessment of quality of life, so the baseline collective was considered with special attention to gender. With regard to the risk factors for the development of heart failure, it was shown that statistically significantly more men had CHD, atrial fibrillation, diabetes mellitus and sleep apnea. It was found that the quality of life of this risk collective (total value PHQ-D: 4.9 (SD: 4.1) points; total value “physical functioning” of the SF-36: 73 (SD: 24) points; total value of the “role limitation because of physical problems” of the SF-36: 67 (SD: 41) points; total value of the “bodily pain” of the SF-36: 69 (SD: 29) points, total value of the “general health” of the SF-36: 61 (SD: 18) points; total value of the “vitality” of the SF-36: 59 (SD: 20) points; total value of the “social functioning” of the SF-36: 82 (SD: 21) points; total value of the “role limitation because of emotional health" of the SF-36: 76 (SD: 38) points; total value of the" mental health" of the SF-36: 71 (SD: 19) points;" physical score component "of the SF-36: 45 (SD: 10) points ; "mental score component" of the SF-36: 50 (SD: 10) points and 6-minute walking distance test 510 (SD: 110) meters) is significantly worse compared to a similar healthy population collective, but it is better than the measured quality of life in an already sick comparison group. An association between a poorer assessment of quality of life and the female sex was found in this study group. The influencing factor "diagnostic recommendation HFpEF of the ESC (2007) positive" showed an association with a poorer evaluation of the qualities "physical functioning" of the SF-36 (-7 points (95% CI: -10 to -4 points)) , "role limitation because of physical problems” of the SF-36 (-7 points (95% CI: -13 to - 2 points)), "vitality" of the SF-36 (3 points (95% CI: -5 to -1 points )), "role limitation because of emotional health" of the SF-36 (-9 points (95% CI: -14 to -3 points)), "physical score component" of the SF-36 (-1 points (95% CI: -3 up to 0 points)) and led to a worse result in the 6-minute walking distance test (-13 meters (95% CI: -26 to 0 meters)). It should be emphasized that there was no interference with gender in any of these associated subqualities. The hazard ratio (cv hospitalization or death) was for +10 scale points for the non-scaled scales “physical functioning”, “role limitation because of physical problems”, “bodily pain”, “general health”, “vitality”, “social functioning” and the "physical score component " significant. After adjustment, there was only a significance for “physical functioning”, “bodily pain”, “vitality” and “social functioning”. Finally, it could be shown again that the quality of life has an overall influence on the patient's probability of death. However, the “physical pain” of the SF-36 was the only sub-quality that had the potential to make a significant statement about the risk of mortality and hospitalization. Conclusion: Compared to the healthy population, patients from a group at risk for HFpEF have a poorer quality of life. If patients have HI signs and symptoms, this always leads to a poorer assessment of all components of quality of life. The influencing factor "diagnostic recommendation HFpEF of the ESC (2007) positive" leads to a worse assessment in some subqualities, but there is never an interference with gender. “Bodily pain” s an independent negative predictive factor of mortality and hospitalization rates.de
dc.contributor.coRefereeMeyer, Thomas Prof. Dr.
dc.subject.engHeart failurede
dc.subject.engQolde
dc.subject.engHFpEFde
dc.subject.engOutcomede
dc.identifier.urnurn:nbn:de:gbv:7-21.11130/00-1735-0000-0008-58C8-4-5
dc.affiliation.instituteMedizinische Fakultätde
dc.subject.gokfullKardiologie (PPN619875755)de
dc.description.embargoed2021-08-17
dc.identifier.ppn1764871413


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