The DOI matches its Crossref record; 49 of the 50 references it cites were found in a registry or an index.
Comparable Performance of the Kansas City Cardiomyopathy Questionnaire in Patients With Heart Failure With Preserved and Reduced Ejection Fraction
Open accessAbstract
Background—: Despite the growing epidemic of heart failure with preserved ejection fraction (HFpEF), no valid measure of patients’ health status (symptoms, function, and quality of life) exists. We evaluated the Kansas City Cardiomyopathy Questionnaire (KCCQ), a validated measure of HF with reduced EF, in patients with HFpEF. Methods and Results—: Using a prospective HF registry, we dichotomized patients into HF with reduced EF (EF≤ 40) and HFpEF (EF≥50). The associations between New York Heart Association class, a commonly used criterion standard, and KCCQ Overall Summary and Total Symptom domains were evaluated using Spearman correlations and 2-way ANOVA with differences between patients with HF with reduced EF and HFpEF tested with interaction terms. Predictive validity of the KCCQ Overall Summary scores was assessed with Kaplan–Meier curves for death and all-cause hospitalization. Covariate adjustment was made using Cox proportional hazards models. Internal reliability was assessed with Cronbach’s α. Among 849 patients, 200 (24%) had HFpEF. KCCQ summary scores were strongly associated with New York Heart Association class in both patients with HFpEF ( r =−0.62; P <0.001) and HF with reduced EF ( r =−0.55; P =0.27 for interaction). One-year event-free rates by KCCQ category among patients with HFpEF were 0 to 25=13.8%, 26 to 50=59.1%, 51 to 75=73.8%, and 76 to 100=77.8% (log rank P <0.001), with no significant interaction by EF ( P =0.37). The KCCQ domains demonstrated high internal consistency among patients with HFpEF (Cronbach’s α=0.96 for overall summary and ≥0.69 in all subdomains). Conclusions—: Among patients with HFpEF, the KCCQ seems to be a valid and reliable measure of health status and offers excellent prognostic ability. Future studies should extend and replicate our findings, including the establishment of its responsiveness to clinical change.
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“The KCCQ is a standardized, 23-item, participant-administered instrument that quantifies heart failurerelated symptoms (frequency, severity, and recent changes), physical function, quality of life, and social function. 16-18 For each domain, the validity, reproducibility, responsiveness, and interpretability have been independently established. 16-18”
From Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity (2023) · cites this paper as [17]
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Statistics notes: Cronbach's alpha: Table 1
Bland, J. M., & Altman, D. G. (1997) · BMJ · doi:10.1136/bmj.314.7080.572 · Cited by 5,300
Trends in Prevalence and Outcome of Heart Failure with Preserved Ejection Fraction
Owan, T., Hodge, D. O., Herges, R. M., Jacobsen, S. J., Roger, V. L., & Redfield, M. M. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa052256 · Cited by 4,209
Green, C. P., Porter, C. B., Bresnahan, D. R., & Spertus, J. A. (2000) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(00)00531-3 · Cited by 1,827 · cited 1×
“Scores were divided into ranges of 0 to 25, 26 to 50, 51 to 75, and 76 to 100, which corresponds to severe, moderate, fair, and little-to-no disability, respectively.(7,11,20) New York Heart Association Functional Class, a physician-assigned assessment of patients’ symptoms and function, was also recorded for each pat…”
BackgroundSelf-citationHFSA 2010 Comprehensive Heart Failure Practice Guideline
Heart Failure Society of America (2010) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2010.04.004 · Cited by 1,304
Heart failure with preserved ejection fraction: pathophysiology, diagnosis, and treatment
Borlaug, B. A., & Paulus, W. J. (2010) · European Heart Journal · doi:10.1093/eurheartj/ehq426 · Cited by 1,136 · cited 5×
“The availability of a tool to measure health status in patients with HFpEF is important in light of increasing evidence suggesting that QOL may be of equally great, or even greater, importance to some patients than decreased mortality, particularly in older patients with HF.35–37 As such, QOL is increasingly recognize…”
BackgroundInfluentialHeart failure with preserved left ventricular systolic function
Hogg, K. J., Swedberg, K. B., & McMurray, J. J. V. (2004) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2003.07.046 · Cited by 927
Systolic and Diastolic Heart Failure in the Community
Bursi, F., Weston, S. A., Redfield, M. M., Jacobsen, S. J., Pakhomov, S., Nkomo, V. T., Meverden, R. A., & Roger, V. L. (2006) · JAMA · doi:10.1001/jama.296.18.2209 · Cited by 891
Meta-analysis Global Group in Chronic Heart Failure (MAGGIC) (2011) · European Heart Journal · doi:10.1093/eurheartj/ehr254 · Cited by 760
Aurigemma, G. P., & Gaasch, W. H. (2004) · New England Journal of Medicine · doi:10.1056/nejmcp022709 · Cited by 759
Flynn, K. E., Piña, I. L., Whellan, D. J., Lin, L., Blumenthal, J. A., Ellis, S. J., Fine, L. J., Howlett, J. G., Keteyian, S. J., Kitzman, D. W., et al. (2009) · JAMA · doi:10.1001/jama.2009.457 · Cited by 737
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Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity
Kosiborod, M. N., Abildstrøm, S. Z., Borlaug, B. A., Butler, J., Rasmussen, S., Davies, M., Hovingh, G. K., Kitzman, D. W., Lindegaard, M. L., Møller, D. V., et al. (2023) · New England Journal of Medicine · doi:10.1056/nejmoa2306963 · Cited by 1,669
Epidemiology of heart failure with preserved ejection fraction
Dunlay, S. M., Roger, V. L., & Redfield, M. M. (2017) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2017.65 · Cited by 1,602
Semaglutide in Patients with Obesity-Related Heart Failure and Type 2 Diabetes
Kosiborod, M. N., Petrie, M. C., Borlaug, B. A., Butler, J., Davies, M. J., Hovingh, G. K., Kitzman, D. W., Møller, D. V., Treppendahl, M. B., Verma, S., et al. (2024) · New England Journal of Medicine · doi:10.1056/nejmoa2313917 · Cited by 758
Shah, S. J., Lam, C. S. P., Svedlund, S., Saraste, A., Hage, C., Tan, R.-S., Beussink-Nelson, L., Ljung Faxén, U., Fermer, M. L., Broberg, M. A., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy531 · Cited by 656
Interpreting the Kansas City Cardiomyopathy Questionnaire in Clinical Trials and Clinical Care
Spertus, J. A., Jones, P. G., Sandhu, A. T., & Arnold, S. V. (2020) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2020.09.542 · Cited by 619
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Metadata
- Authors
- Joseph, S. M., Novak, E., Arnold, S. V., Jones, P. G., Khattak, H., Platts, A. E., Dávila-Román, V. G., Mann, D. L., & Spertus, J. A.
- Affiliations
- Washington University in St. Louis (US)
- From the Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St Louis, MO (S.M.J., E.N., H.K., A.E.P., V.G.D.-R., D.L.M.); and Saint Luke’s Mid-America Heart Institute, University of Missouri, Kansas City (S.V.A., P.G.J., J.A.S.).
- Venue
- Circulation: Heart Failure
- Published
- 2013-11
- Volume
- 6
- Issue
- 6
- Pages
- 1139-1146
- ISSN
- 1941-3289 (ISSN-L)
- 1941-3297
- PMC
- PMC4545244
- OpenAlex
- W2547126679
- Cited by
- 192
- References
- 50
- Citations by year
- 2026: 12 · 2025: 18 · 2024: 28 · 2023: 24 · 2022: 16 · 2021: 24 · 2020: 20 · 2019: 13 · 2018: 10 · 2017: 11 · 2016: 6 · 2015: 7 · 2014: 3
- FWCI
- 3.63
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Circulation Heart Failure (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Funders
- National Heart, Lung, and Blood Institute (U10HL110309, RC2HL102222)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart rate and cardiovascular health
- Keywords
- Kansas City Cardiomyopathy Questionnaire, heart failure with preserved ejection fraction, heart failure with reduced ejection fraction, health status measurement, quality of life, symptom burden, NYHA functional class, prognostic validity, mortality, hospitalization, internal consistency
- MeSH terms
- Female, Follow-Up Studies, Health Status, Heart Failure, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Quality of Life, Surveys and Questionnaires, Severity of Illness Index, Stroke Volume, United States, Reproducibility of Results, Incidence, Disease Progression
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