Impact of non-cardiovascular comorbidities on the quality of life of patients with chronic heart failure: a scoping revi
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REVIEW
Impact of non‑cardiovascular comorbidities on the quality of life of patients with chronic heart failure: a scoping review Josep Comín‑Colet1,2, Teresa Martín Lorenzo3, Almudena González‑Domínguez3* , Juan Oliva4 and Silvia Jiménez Merino5
Abstract Purpose: To determine the impact of non-cardiovascular comorbidities on the health-related quality of life (HRQoL) of patients with chronic heart failure (CHF). Methods: A scoping review of the scientific literature published between 2009 and 2019 was carried out. Observa‑ tional studies which assessed the HRQoL of patients with CHF using validated questionnaires and its association with non-cardiovascular comorbidities were included. Results: The search identified 1904 studies, of which 21 fulfilled the inclusion criteria to be included for analysis. HRQoL was measured through specific, generic, or both types of questionnaires in 72.2%, 16.7%, and 11.1% of the studies, respectively. The most common comorbidities studied were diabetes mellitus (12 studies), mental and behav‑ ioral disorders (8 studies), anemia and/or iron deficiency (7 studies), and respiratory diseases (6 studies). Across studies, 93 possible associations between non-cardiovascular comorbidities and HRQoL were tested, of which 21.5% regarded anemia or iron deficiency, 20.4% mental and behavioral disorders, 20.4% diabetes mellitus, and 14.0% respiratory dis‑ eases. Despite the large heterogeneity across studies, all 21 showed that the presence of a non-cardiovascular comor‑ bidity had a negative impact on the HRQoL of patients with CHF. A statistically significant impact on worse HRQoL was found in 84.2% of associations between mental and behavioral disorders and HRQoL (patients with depression had up to 200% worse HRQoL than patients without depression); 73.7% of associations between diabetes mellitus and HRQoL (patients with diabetes mellitus had up to 21.8% worse HRQoL than patients without diabetes mellitus); 75% of associations between anemia and/or iron deficiency and HRQoL (patients with anemia and/or iron deficiency had up to 25.6% worse HRQoL than between patients without anemia and/or iron deficiency); and 61.5% of associa‑ tions between respiratory diseases and HRQoL (patients with a respiratory disease had up to 21.3% worse HRQoL than patients without a respiratory disease). Conclusion: The comprehensive management of patients with CHF should include the management of comorbidi‑ ties which have been associated with a worse HRQoL, with special emphasis on anemia and iron deficiency, mental and behavioral disorders, diabetes mellitus, and respiratory diseases. An adequate control of these comorbidities may have a positive impact on the HRQoL of patients. Keywords: Heart failure, Health-related quality of life, Comorbidity, Chronic disease
*Correspondence: [email protected] 3 Weber, Madrid, Spain Full list of author information is available at the end of the article
Introduction Chronic heart failure (CHF) is a disease caused by structural or
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