Patient-Reported Health Status Assessment Using the KCCQ for Early Detection of Heart Failure Worsening

Inclusion criteria

• Established diagnosis of chronic HF with reduced, mildly reduced, or preserved ejection fraction, NYHA II-III
• History of heart failure (HF) hospitalization within the last 6 months before enrollment, defined as the presence of dyspnea, elevated NT-proBNP ≥300 pg/mL (sinus rhythm) or ≥600 pg/mL (if AF), and 2 of the following: i. Rales on chest auscultation or signs of congestion on X-ray/CT scan; ii. Peripheral Oedema; iii. Loop diuretics IV at admission
• Free of signs and symptoms of congestion, defined as JVP of \<8 cm, with no orthopnea, pulmonary rales, and with trace peripheral edema or no edema.
• Stable doses of oral loop diuretics, if prescribed
• Ability to provide informed consent

Exclusion criteria

• Acute coronary syndrome, cardiac surgery, pulmonary embolism, cerebrovascular accident, ablation of atrial flutter/fibrillation, valve repair/replacement, implanted cardioverter defibrillator or urgent PCI within the last 3 months
• Planned interventions, including major cardiac surgery (coronary artery bypass grafting, valve repair/replacement, ventricular assist device, cardiac transplantation), coronary revascularization, implantation of a cardiac device or ablation of atrial flutter/fibrillation during the study
• Previous cardiac transplantation and candidates for heart transplantation
• Complex congenital heart disease
• Heart failure due to active myocarditis, pericardial constriction, known hypertrophic cardiomyopathy or cardiac amyloidosis, or uncorrected severe valvular heart disease
• Primary pulmonary hypertension, chronic pulmonary embolism, severe pulmonary disease
• Cirrhosis, chronic active hepatitis, or other severe hepatic disease
• Significant drug or alcohol abuse during the last year
• Hemodialysis
• Infective endocarditis
• Any active cancer