左室のisolated diastolic dysfunctionを有する外来患者の臨床像収縮機能障害を有する患者との比較検討

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Comparison of Health-Related Quality of Life Between Patients With Systolic Dysfunction and Those with Isolated Diastolic Dysfunction -Niigata Sado Heart Failure study- Background The impact of pathological subtypes of cardiac dysfunction on the health-related quality of life (HRQOL) is of great interest but insufficiently appreciated. Objective and methods To evaluate HRQOL of outpatients with systolic dysfunction (SD) and isolated diastolic dysfunction (IDD), outpatients aged 60-84 years were extracted from the records of 4,500 consecutive individuals who had echocardiographic examinations in Sado City. The medical records were reviewed and the Medical Outcome Study Short Form 36 (SF-36) was mailed to them. Results A total of 417SD and 227IDD patients were extracted from 2000 to 2002, but 267SD and 188IDD patients were alive at end of 2004. Answers were obtained only from 215SD and 145IDD patients. SD and IDD showed a similar pattern of impairment of HRQOL in both its mental and physical aspects ; especially physical functioning and general health. There was no significant difference in HRQOL between SD patients and IDD patients stratified by age and gender. A reduction of HRQOL subscales significantly correlated with the limitation of exercise capacity. Conclusions Impaired HRQOL is a serious problem for SD and IDD patients. Exercise intolerance is a proposed patho-physiologic mechanism underlying the reduction of HRQOL.