Functional and Quality of Life Outcomes in Heart Failure Patients at a Specialized Heart Failure Clinic in Dhaka, Bangladesh.

BACKGROUND

Managing heart failure patients in resource-limited settings presents significant challenges, with limited data on quality of life and functional outcomes. This study investigated these outcomes in patients attending a heart failure clinic (HFC) in Dhaka, Bangladesh.

METHODS

Data were analyzed from 454 patients registered between January 2016 and December 2021 at the HFC of the United Hospital Limited, Dhaka, Bangladesh, who had baseline and follow-up data, including left ventricular ejection fraction (LVEF). A multivariable logistic regression model using generalized estimating equations identified predictors of ≥5% LVEF improvement.

RESULTS

Patients averaged 58.4 ± 11.4 years, with 80.4% being male. Median baseline LVEF was 35% (IQR: 30-40). At baseline, 77.3% had heart failure with reduced ejection fraction (HFrEF), 10.1% had heart failure with mid-range ejection fraction (HFmrEF), and 12.6% had heart failure with preserved ejection fraction (HFpEF). LVEF improved in 39.6% of patients, while quality of life improved in 16.1%. Significant predictors of ≥5% LVEF improvement included age (adjusted odds ratio (aOR): 0.97; 95% CI: 0.95-0.99), female sex (aOR: 2.13; 95% CI: 1.21-3.73), history of acute kidney injury (aOR: 0.12; 95% CI: 0.02-0.81), and baseline HFrEF (aOR: 2.90; 95% CI: 1.34-6.26).

CONCLUSION

These findings underscore the need for tailored heart failure management approaches in resource-limited settings that consider patient-specific factors alongside dedicated interventions to improve quality of life.