Prevalence of Severity-based Evaluation of Heart Failure (PROBE) and its Impact on Health-related Quality of Life: An Observational Study


  • Abdul Ghaffar Memon Liaquat University of Medical & Health Sciences, Jamshoro, Pakistan
  • Muhammad Nauman Khan National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan
  • Hesham Naeem Rawalpindi Institute of Cardiology, Rawalpindi, Pakistan
  • Fazal Aziz Mian Pakistan Institute of Medical Sciences, Islamabad, Pakistan
  • Muhammad Imran Khan Ayub Medical Teaching Hospital, Abbottabad, Pakistan
  • Farooq Ahmad Khyber Teaching Hospital, Peshawar, Pakistan
  • Ahmad Fawad Northwest General Hospital, Peshawar, Pakistan
  • Khalid Razaq Sheikh Zayed Hospital, Rahim Yar Khan, Pakistan
  • Abdul Rab Shaikh District Head Quarter Hospital Jamshoro, Kotri, Pakistan



Objectives: The study aims to evaluate the severity of heart failure (HF) and its impact on the patient's quality of life (QoL).

Methodology: A multicenter, observational study was conducted across 100 medical facilities in Pakistan. Symptomatic HF patients (NYHA Class-II to IV) diagnosed ≥ 1 year ago, aged ≥ 18 years, and advised for echocardiography were invited. A total of 961 patients agreed to participate. HF severity was assessed based on ejection fraction (EF %) and NYHA class. The Kansas City Cardiomyopathy Questionnaire (KCCQ) was used to assess the effect of HF on the patient's QoL.

Results: The patients' overall health status exhibited poor scores, with a mean KCCQ score of 20.26±8.34. Concerning left ventricular ejection fraction (LVEF), 25.9% of patients displayed moderate dysfunction (LVEF 30% to 39%), while 29.1% had severe dysfunction (LVEF < 30%). The distribution across NYHA classes was Class II included 451 patients (46.9%), Class III included 317 patients (33.0%), and Class IV included 193 patients (20.1%). High-quality-of-life (HR-QoL) assessments using the KCCQ exhibited significant correlations with both LVEF (rs=-0.394, p<0.01) and NYHA class (rs=-0.615, p<0.01). Notably, the mean KCCQ score displayed considerable variation across NYHA classes, Class II had a mean score of 25.42±7.95, Class III had 20.90±7.67, and Class IV had 16.41±8.94. Significant predictors of quality of life (KCCQ score) included age and NYHA.

Conclusion: It is concluded from the study results that HR-QoL is significantly correlated with the severity of HF based on ejection fraction and NYHA class.


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How to Cite

Memon AG, Khan MN, Naeem H, Mian FA, Khan MI, Ahmad F, Fawad A, Razaq K, Shaikh AR. Prevalence of Severity-based Evaluation of Heart Failure (PROBE) and its Impact on Health-related Quality of Life: An Observational Study. Pak Heart J [Internet]. 2023Sep.30 [cited 2024Mar.3];56(3):219-23. Available from:



Original Article