# Functional and Quality of Life Outcomes in Heart Failure Patients at a Specialized Heart Failure Clinic in Dhaka, Bangladesh

## TL;DR

This study examines heart failure outcomes in Bangladesh, finding that many patients improve in function but quality of life remains a challenge.

## Contribution

The study provides insights into heart failure management and outcomes in a resource-limited setting in Bangladesh.

## Key findings

- 39.6% of patients showed improvement in left ventricular ejection fraction.
- 16.1% of patients reported improved quality of life.
- Female sex and baseline heart failure with reduced ejection fraction were significant predictors of LVEF improvement.

## Abstract

Background: Managing heart failure patients in resource-limited settings presents significant challenges, with limited data on quality of life and functional outcomes. This study investigated these outcomes in patients attending a heart failure clinic (HFC) in Dhaka, Bangladesh.

Methods: Data were analyzed from 454 patients registered between January 2016 and December 2021 at the HFC of the United Hospital Limited, Dhaka, Bangladesh, who had baseline and follow-up data, including left ventricular ejection fraction (LVEF). A multivariable logistic regression model using generalized estimating equations identified predictors of ≥5% LVEF improvement.

Results: Patients averaged 58.4 ± 11.4 years, with 80.4% being male. Median baseline LVEF was 35% (IQR: 30-40). At baseline, 77.3% had heart failure with reduced ejection fraction (HFrEF), 10.1% had heart failure with mid-range ejection fraction (HFmrEF), and 12.6% had heart failure with preserved ejection fraction (HFpEF). LVEF improved in 39.6% of patients, while quality of life improved in 16.1%. Significant predictors of ≥5% LVEF improvement included age (adjusted odds ratio (aOR): 0.97; 95% CI: 0.95-0.99), female sex (aOR: 2.13; 95% CI: 1.21-3.73), history of acute kidney injury (aOR: 0.12; 95% CI: 0.02-0.81), and baseline HFrEF (aOR: 2.90; 95% CI: 1.34-6.26).

Conclusion: These findings underscore the need for tailored heart failure management approaches in resource-limited settings that consider patient-specific factors alongside dedicated interventions to improve quality of life.