The Heterogeneity of Physical and Anxiety Symptoms and Quality of Life Among Patients With Heart Failure: A Latent Class Analysis.

ABSTRACT

BACKGROUND: Patients with heart failure (HF) experience a severe burden of symptoms and reduced quality of life (QoL). However, little is known about the heterogeneity of these symptoms and the association with QoL. OBJECTIVES: The aims of this study were to conduct a latent class analysis on co-occurring physical and anxiety symptoms and to determine whether the underlying subgroups differ regarding the QoL among patients with HF. METHODS: The authors of this cross-sectional study recruited 329 patients with HF from 2 hospitals. Patients' symptoms and QoL were self-reported, and data were analyzed using latent class analysis, χ 2 test, analysis of variance, and hierarchical linear regression analysis. RESULTS: Three latent classes (all low, all high, and high physical-partial anxiety) were identified based on the occurrence of patients' physical and anxiety symptoms. Patients with a lower body mass index, a worse New York Heart Association class, and a longer disease duration were more likely to belong to the all-high class. Hierarchical linear regression analysis showed that distinct subgroups (all low vs all high ß = -0.299, P < .001; all low vs high physical-partial anxiety ß = -0.228, P < .001) were significantly associated with the physical summary component score for QoL. Likewise, distinct subgroups (all low vs all high ß = -0.509, P < .001; all low vs high physical-partial anxiety ß = -0.128, P = .012) were significantly associated with the mental summary component score for QoL. CONCLUSIONS: Patients with HF showed heterogeneity in physical and anxiety symptoms; the subgroup with severe symptoms exhibited a poor QoL. The associations between symptom subgroups and QoL require targeted symptom-based interventions.