Impact of cardiac resynchronisation therapy on patient-reported health status: a prospective real-world Kansas City Cardiomyopathy Questionnaire study
M Camara Farinha, I Barroso Almeida, I Santos, V Pereira Ferreira, F Duarte, L Oliveira, C Machado, A Monteiro, M PachecoAbstract
Background
Cardiac resynchronisation therapy (CRT) improves outcomes in selected patients with heart failure and electrical desynchrony. However, patient-reported health status remains underrepresented in routine clinical evaluation. The Kansas City Cardiomyopathy Questionnaire (KCCQ) provides a validated assessment of symptoms, functional limitation and quality of life.
Purpose
To evaluate patient-reported health status changes following CRT implantation using the KCCQ Overall Summary Score.
Methods
Consecutive patients undergoing CRT implantation were prospectively evaluated at our centre. KCCQ was completed at baseline and at 6-month follow-up. Of 28 enrolled patients, one died from cardiovascular causes before follow-up. KCCQ scores were calculated according to standard methodology and transformed to a 0–100 scale , with higher scores indicating better health status. The primary endpoint was change in KCCQ Overall Score. Clinically meaningful improvement was defined as a ≥5-point increase.
Results
The study population had a mean age of 70 years, with a predominance of male patients (71%). Sinus rhythm was present in 64.3%, and most patients (71.4%) underwent implantation of cardiac resynchronisation therapy with a defibrillator. Median KCCQ Overall Score improved from 93.8 [IQR 53.1] at baseline to 102.5 [IQR 49.0] at follow-up (Z=3.56, p<0.001). Median improvement was +8.5 points. A clinically meaningful response occurred in 70.4% of patients, with deterioration observed in only three. Improvements were consistent across physical and social limitation domains.
Conclusion
CRT confers substantial improvement in patient-reported quality of life in a real-world heart failure population, emphasising the value of patient-centred outcome assessment.