Quality of life in patients with atrial fibrillation taking into account the phenotype of heart failure
Authors: Kulaiets N.M. , Kulaiets V.M. 
Published: November 2023

Atrial fibrillation (AF) is a medical problem often associated with several comorbidities and adverse outcomes. In developed countries, chronic heart failure (CHF), which affects 2% to 3% of the population, is also a major cause of morbidity and mortality. The prevalence of both of these diseases is steadily increasing worldwide. CHF with AF is gaining more and more medical and social significance, as it can worsen the prognosis and quality of life (QoL) of a person. The purpose. Assess the quality of life of patients with atrial fibrillation, taking into account the phenotype of heart failure.Material and methods. 300 patients aged 45-65 were examined. Among the examined were 180 (60.0%) women and 120 (40.0%) men. All patients were divided into groups: group I – control, 36 practically healthy persons; group II - patients with CHF with AF and preserved left ventricular ejection fraction (LVHF, n=190); group III - patients with HF with AF and reduced left ventricular ejection fraction (LVHF, n=110). Diagnoses of AF and HF were carried out according to the clinical protocol for providing medical care to patients with atrial fibrillation and heart failure, confirmed by the order of the Ministry of Health of Ukraine №436 of 07.03.2006. The quality of life (QoL) of the patients was assessed using a non-specific questionnaire Medical Outcomes Study 36-Item Short-Form Health Survey (MOS SF-36) and Minnesota living with heart failure questionnaire (MHFLQ).Research results. According to the results of the Minnesota Questionnaire (MLHFQ), patients with HF and AF had higher scores, indicating a worse quality of life (p<0.05). The highest indicators of the quality of life according to the scale of physical and mental health (p<0.05) were established in the control group. In patients with chronic heart failure with atrial fibrillation, significant differences were found, compared to the control group, on the scales of physical (p<0.05), physical-role functioning (p<0.05), pain intensity (p<0.05) and emotional role functioning (p<0.05). It was found that in patients with a reduced left ventricular ejection fraction, compared to patients with a preserved left ventricular ejection fraction, a significant decrease in quality of life indicators on almost all SF-36 scales was set: physical functioning (p<0.05), role functioning (p< 0.05), body pain (p<0.05), general health (p<0.05), vital activity (p<0.05). It has been proven that male gender (p<0.05), age over 65 years (p<0.05), increased body mass index (BMI, p<0.05), impaired glucose tolerance/or diabetes mellitus type 2 (p <0.05) and arterial hypertension (p<0.05) were factors associated with HF and, accordingly, lower quality of life scores according to the SF-36 questionnaire. Probable dependence regarding smoking (p>0.05) and hyperlipidemia (p>0.05) in components of physical and mental health in patients with CHF and AF were not established.Conclusion. According to the results of the Minnesota Questionnaire (MLHFQ), patients with HF and AF had higher scores, indicating a worse quality of life (p<0.05). In the examined patients for chronic heart failure with atrial fibrillation, a decrease in quality of life indicators was found in comparison with the control group on all scales of the SF-36 questionnaire (p<0.05). Significant differences were established, compared to the control group, on the scales of physical (p<0.05), physical-role functioning (p<0.05), pain intensity (p<0.05) and emotional-role functioning (p<0 ,05). It was found that in patients with a reduced left ventricular ejection fraction, compared to patients with a preserved left ventricular ejection fraction, there is a significant decrease in quality of life indicators on almost all SF-36 scales: physical functioning (p<0.05), role functioning ( p<0.05), body pain (p<0.05), general health (p<0.05), vital activity (p<0.05). At the same time, on the scales of social functioning and mental health, there were no significant differences, depending on the left ventricular ejection fraction in atrial fibrillation (p>0.05).