Perfil clínico y calidad de vida de pacientes hospitalizados con insuficiencia cardíaca descompensada:
análisis transversal de un ensayo clínico aleatorizado
DOI:
https://doi.org/10.15448/2357-9641.2026.1.49434Palabras clave:
insuficiencia cardíaca, Calidad de vida, HospitalizaciónResumen
La insuficiencia cardíaca (IC) se asocia a diversas comorbilidades y a un tratamiento complejo, lo que compromete la calidad de vida (CdV) de los pacientes. Objetivo: evaluar el perfil y la CdV de pacientes con IC descompensada al momento de ingresar a una intervención de educación para la salud. Método: Estudio observacional transversal, integrado en un ensayo clínico aleatorizado. Se incluyeron pacientes mayores de 18 años hospitalizados en un hospital de Porto Alegre. Se aplicaron el Cuestionario de Miocardiopatía de la Ciudad de Kansas (KCCQ) y la Escala Hospitalaria de Ansiedad y Depresión (HADS). Resultados: Se evaluaron 65 pacientes, con una media de edad de 64,5 ± 13,1 años, varones (56,9%), IMC de 27,0 ± 5,2 kg/m2 y CC de 98,8 ± 15,1 cm. La etiología isquémica fue la más frecuente (50,8%), la FEVI media fue de 38,1 ± 18,0%, la IC-FEr (66,2%), la clase funcional III (47,7%) y el perfil clínico-hemodinámico cálido y húmedo (84,6%). En la puntuación del KCCQ, los pacientes ya diagnosticados con IC tuvieron puntuaciones más altas en Limitación Social (p = 0,043) en comparación con los diagnosticados en la hospitalización. En los pacientes de clase IV de la NYHA, las puntuaciones de los subítems Limitación Física (p = 0,003), Frecuencia (p = 0,022) y Gravedad (p = 0,044) del dominio Síntomas, Puntuación Total de Síntomas (p = 0,014) y Calidad de Vida (p = 0,030) fueron inferiores a las de los pacientes de clase I de la NYHA. La mayoría fue clasificada como sin ansiedad (55,4%) y sin depresión (75,4%). Conclusiones: Los pacientes con clase IV de la NYHA en comparación con los pacientes con clase I presentaron puntuaciones más bajas en las áreas de Limitación Física, Síntomas (Frecuencia y Gravedad) y Calidad de Vida, además de la puntuación total de síntomas. La FEVI y los niveles de ansiedad y depresión no mostraron diferencias significativas en relación con la CdV de los pacientes con insuficiencia cardíaca.
Descargas
Citas
McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Bohm M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J [Internet]. 2021 [citado 14 Ago 2026];42(36):3599–726. Disponível em: https://doi.org/10.1093/eurheartj/ehab368
Rohde LEP, Montera MW, Bocchi EA, Clausell NO, Albuquerque DC, Rassi S, et al. Diretriz Brasileira de Insuficiência Cardíaca Crônica e Aguda. Arq Bras Cardiol [Internet]. 2018 [citado 14 Ago 2026];111(3):436–539. Disponível em: https://doi.org/10.5935/abc.20180190
Bozkurt B, Coats AJS, Tsutsui H, Abdelhamid CM, Adamopoulos S, Albert N, et al. Universal definition and classification of heart failure: a report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure: Endorsed by the Canadian Heart Failure Society, Heart Failure Association of India, Cardiac Society of Australia and New Zealand, and Chinese Heart Failure Association. Eur J Heart Fail [Internet]. 2021 [citado 14 Ago 2026];23(3):352–80. Disponível em: https://doi.org/10.1002/ejhf.2115
Savarese G, Becher PM, Lund LH, Seferovic P, Rosano GMC, Coats AJS. Global burden of heart failure: a comprehensive and updated review of epidemiology. Cardiovasc Res [Internet]. 2023 [citado 14 Ago 2026];118(17):3272−87. Disponível em: https://doi.org/10.1093/cvr/cvac013
Wang N, Hales S, Tofler G. 15-year trends in patients hospitalised with heart failure and enrolled in an Australian heart failure management program. Hear Lung Circ [Internet]. 2019 [citado 14 Ago 2026];28(11):1646–54. Disponível em: https://www.heartlungcirc.org/article/S1443-9506(18)31951-6/abstract
Nave-Leal E, Pais-Ribeiro J, Oliveira Mm, Silva N, Soares R, Fragata J, et al. Propriedades psicométricas da versão portuguesa do Kansas City Cardiomyopathy Questionnaire na miocardiopatia dilatada com insuficiência cardíaca congestiva. Rev Port Cardiol [Internet]. 2010 [citado 14 Ago 2026];29(3):353–72. Disponível em: https://repositorio-aberto.up.pt/bitstream/10216/39382/2/86512.pdf
Spertus JA, Jones PG, Sandhu AT, Arnold SV. Interpreting the Kansas City Cardiomyopathy Questionnaire in Clinical Trials and Clinical Care: JACC State-of-the-Art Review. J Am Coll Cardiol [Internet]. 2020 [citado 14 Ago 2026];76(20):2379–90. Disponível em: https://www.jacc.org/doi/10.1016/j.jacc.2020.09.542
Gomes ET, Bezerra SMMS. Validade da Escala Hospitalar de Ansiedade e Depressão no período pré-operatório de cirurgia cardíaca. Enferm Bras [Internet]. 2018 [citado 14 Ago 2026];17(3):273–8. Disponível em: https://portalatlanticaeditora.com.br/index.php/enfermagembrasil/article/download/1126/3757
Mukaka MM. Statistics corner: A guide to appropriate use of correlation coefficient in medical research. Malawi Med J [Internet]. 2012 [citado 14 Ago 2026];24(3):69–71. Disponível em: https://pmc.ncbi.nlm.nih.gov/articles/PMC3576830/
Albuquerque DC, Souza Neto JD, Bacal F, Rohde LE, Bernardez-Pereira S, Berwanger O, et al. Estudo BREATHE. I Brazilian Registry of Heart Failure - Clinical Aspects, Care Quality and Hospitalization Outcomes. Arq Bras Cardiol [Internet]. 2015 [citado 14 Ago 2026];104(6):433–42. Disponível em: https://doi.org/10.5935/abc.20150031
Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, et al. Heart Disease and Stroke Statistics-2021 Update: A Report from the American Heart Association. Circulation [Internet]. 2021 [citado 14 Ago 2026];143(8):e254–e743. Disponível em: https://doi.org/10.1161/CIR.0000000000000950
Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, et al. American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data from the American Heart Association. Circulation [Internet]. 2024 [citado 14 Ago 2026];149(8):e347–e913. Disponível em: https://doi.org/10.1161/CIR.0000000000001209
Halpern B, Mancini MC, de Melo ME, Lamounier RN, Moreira RO, Carra MK, et al. Proposal of an obesity classification based on weight history: an official document by the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Society for the Study of Obesity and Metabolic Syndrome (ABESO). Arch Endocrinol Metab [Internet]. 2022 [citado 14 Ago 2026]; 28;66(2):139–51. Disponível em: https://doi.org/10.20945/2359-3997000000501
Ross R, Neeland IJ, Yamashita S, Shai I, Seidell J, Magni P, et al. Waist circumference as a vital sign in clinical practice: A Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity. Nat Rev Endocrinol [Internet]. 2020 [citado 14 Ago 2026];16(3):177–89. Disponível em: https://pmc.ncbi.nlm.nih.gov/articles/PMC7027970/
Powell-Wiley TM, Poirier P, Burke LE, Després JP, Gordon- Larsen P, Lavie CJ, et al. Obesity and Cardiovascular Disease: A Scientific Statement from the American Heart Association. Circulation [Internet]. 2021 [citado 14 Ago 2026];143(21):e984–e1010. Disponível em: https://doi.org/10.1161/CIR.0000000000000973
Souza MV, Nascimento LF, Kozlowsky I, Farjun B, França K, Kuriyama SN, et al. Impacts of heart failure on the Brazilian health and pension system: What is the cost of the disease? J Bras Econ Saúde [Internet]. 2022 [citado 14 Ago 2026];14(2):149–61. Disponível em: https://doi.org/10.21115/JBES.v14.n2.p149-61
Udani K, Patel D, Mangano A. A Retrospective Study of Admission NT-proBNP Levels as a Predictor of Readmission Rate, Length of Stay and Mortality. HCA Healthc J Med [Internet]. 2021 [citado 14 Ago 2026];2(3):207–14. Disponível em: https://pmc.ncbi.nlm.nih.gov/articles/PMC10324821/.
Rohde LE, Zimerman A, Vaduganathan M, Claggett BL, Packer M, Desai AS, et al. Associations Between New York Heart Association Classification, Objective Measures, and Long-term Prognosis in Mild Heart Failure: A Secondary Analysis of the PARADIGM-HF Trial. JAMA Cardiol [Internet]. 2023 [citado 14 Ago 2026];8(2):150–58. Disponível em: https://jamanetwork.com/journals/jamacardiology/fullarticle/2799381
Marcondes-Braga FG, Moura LAZ, Issa VS, Vieira JL, Rohde LE, Simões MV, et al. Atualização de Tópicos Emergentes da Diretriz de Insuficiência Cardíaca – 2021. Arq Bras Cardiol [Internet]. 2021 [citado 14 Ago 2026];116(6):1174−212. Disponível em: https://doi.org/10.36660/abc.20210367
Maddox, T, Januzzi, J. et al. 2024 ACC Expert Consensus Decision Pathway for Treatment of Heart Failure with Reduced Ejection Fraction: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol [Internet]. 2024 [citado 14 Ago 2026];83(15):1446−87. Disponível em: https://doi.org/10.1016/j.jacc.2023.12.024
Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of
the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation [Internet]. 2022 [citado 14 Ago 2026];145:e895–e1032. Disponível em: https://doi.org/10.1161/CIR.0000000000001063
Brasil. Ministério da Saúde. Portaria SCTIE/MS nº 63, de 7 de julho de 2022 [Internet]. Brasília; 2002 [citado 14 Ago 2026]. Disponível em: https://bvsms.saude.gov.br/bvs/saudelegis/sctie/2022/prt0063_11_07_2022.html
Rohde LE, Hoffmann Filho CR, Rover MM, Rabelo-Silva ER, Lopez L, Passos LCS, et al. Design of a multifaceted strategy based on automated text messaging in patients with recent heart failure admission. ESC Heart Fail [Internet]. 2021 [citado 14 Ago 2026];8(6):5523−30. Disponível em: https://doi.org/10.1002/ehf2.13516
Spertus JA, Jones PG. Development and Validation of a Short Version of the Kansas City Cardiomyopathy Questionnaire. Circ Cardiovasc Qual Outcomes [Internet]. 2015 [citado 14 Ago 2026];8(5):469–76. Disponível em: https://doi.org/10.1161/CIRCOUTCOMES.115.001958
Yee D, Novak E, Platts A, Nassif ME, LaRue SJ, Vader JM. Comparison of the Kansas City Cardiomyopathy Questionnaire and Minnesota Living with Heart Failure Questionnaire in Predicting Heart Failure Outcomes. Am J Cardiol [Internet]. 2019 [citado 14 Ago 2026];123(5):807–12. Disponível em: https://www.ajconline.org/article/S0002-9149(18)32142-8/abstract
Hu, D, Liu, J, Zhang, L, Bai, X, Tian, A, Huang, X, et al. Health Status Predicts Short- and Long-Term Risk of Composite Clinical Outcomes in Acute Heart Failure. J Am Coll Cardiol HF [Internet]. 2021 [citado 14 Ago 2026];9(12)861–73. Disponível em: https://doi.org/10.1016/j.jchf.2021.06.015
Johansson I, Joseph P, Balasubramanian K, McMurray JJV, Lund LH, Ezekowitz JA, et al. Health-Related Quality of Life and Mortality in Heart Failure: The Global Congestive Heart Failure Study of 23 000 Patients from 40 Countries. Circulation [Internet]. 2021 [citado 14 Ago 2026];143(22):2129–42. Disponível em: https://doi.org/10.1161/CIRCULATIONAHA.120.050850
Van den Berge JC, van Vark LC, Postmus D, Utens EMWJ, Hillege HL, Boersma E, Lesman-Leegte I, Akkerhuis KM. Determinants of quality of life in acute heart failure patients with and without comorbidities: a prospective, observational study. Eur J Cardiovasc Nurs [Internet]. 2022 [citado 14 Ago 2026];21(3):205–12. Disponível em: https://doi.org/10.1093/eurjcn/zvab061
Melo ALFV, Araújo RF, Viana LRC, Silva CRR, Freitas SA, Costa KNFM. Symptoms of depression and social support in people with heart failure: an integrative review. Saúde Colet. (Barueri, Impr.) [Internet]. 2023 [citado 14 Ago 2026];13(88):13231–46. Disponível em: https://doi.org/10.36489/saudecoletiva.2023v13i88p13231-13246
Soares VL, Pereira C, Carvalho AC, Mota TP, Groehs RV, Bacal F, et al. Prevalence and Association Between Cognition, Anxiety, and Depression in Patients Hospitalized with Heart Failure. Int J Cardiovasc Sci [Internet]. 2022 [citado 14 Ago 2026];36:e20210226. Disponível em: https://doi.org/10.36660/ijcs.20210226
Rasmussen AA, Larsen SH, Jensen M, Berg SK, Rasmussen TB, Borregaard B, et al. Prognostic impact of self-reported health on clinical outcomes in patients with heart failure. Eur Heart J Qual Care Clin Outcomes [Internet]. 2021 [citado 14 Ago 2026];7(4):397–406. Disponível em: https://doi.org/10.1093/ehjqcco/qcaa026
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2026 Brenda Gonçalves Donay Alves, Ellen Hettwer Magedanz, Andréia da Silva Gustavo , Luiz Carlos Bodanese
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
