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

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, chi(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: beta = -0.299, P < .001; all low vs high physical-partial anxiety: beta = -0.228, P < .001) were significantly associated with the physical summary component score for QoL. Likewise, distinct subgroups (all low vs all high: beta = -0.509, P < .001; all low vs high physical-partial anxiety: beta = -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.