Tesis

Faktor-Faktor yang Memengaruhi Kualitas Hidup Pasien Gagal Jantung Kronik Fraksi Ejeksi Terjaga (HFpEF) Rawat Jalan di RSUPN dr. Cipto Mangunkusumo = Factors Affecting the Quality of Life in Patients with Chronic Heart Failure Preserved Ejection Fraction (HFpEF) in Outpatient Clinic at Cipto Mangunkusumo Hospital.

Latar belakang: Prevalensi gagal jantung di Indonesia pada usia dewasa sebesar 1,5%, setidaknya setengahnya merupakan gagal jantung fraksi ejeksi terjaga (HFpEF). Pengukuran kualitas hidup berperan penting dalam penanganan gagal jantung, salah satunya menggunakan kuesioner Minnesota Living with Heart Failure (MLHF). Di Indonesia, belum ada data mengenai faktor risiko yang mempengaruhi kualitas hidup pasien HFpEF. Tujuan: Mengetahui profil kualitas hidup pasien HFpEF dan hubungan antara faktor risiko usia, hipertensi, DM, merokok, dan obesitas terhadap kualitas hidup pasien HFpEF. Metode: Desain studi potong lintang, data diambil dari pasien HFpEF dewasa ( > 18 tahun) berdasarkan ekokardiografi dalam 6 bulan terakhir yang berkunjung ke Poliklinik Jantung Terpadu Rumah Sakit dr. Cipto Mangunkusumo sejak Januari 2022 sampai Desember 2023. Pengukuran kualitas hidup dilakukan dengan kuesioner MLHF. Analisis bivariat dilakukan untuk mencari hubungan antara faktor risiko (usia, jenis kelamin, hipertensi, DM, merokok, dan obesitas) dan kualitas hidup pasien. Analisis multivariat dilakukan untuk variabel hipertensi, DM, jenis kelamin, dan usia. Hasil: Dari 206 subjek, 72,33% pasien dominan domain item fisik dan 27,67% pasien dominan domain item emosional. Mayoritas pasien dominan item fisik memiliki kualitas hidup keseluruhan baik. Mayoritas pasien dominan item emosional memiliki kualitas hidup baik. Tidak ditemukan hubungan bermakna antara domain item yang dominan terhadap kualitas hidup pasien HFpEF. Tidak terdapat hubungan bermakna antara faktor sosio-demografis dan faktor risiko terhadap domain item dominan. Terdapat hubungan bermakna antara faktor usia (p=0,005), jenis kelamin (p=0,001), dan riwayat merokok (p=0,001) dengan kualitas hidup pasien dengan HFpEF. Pasien dewasa memiliki kualitas hidup lebih buruk dibanding pasien lansia (OR= 0,33 [IK95% 0,17-0,66]). Tidak ditemukan hubungan yang bermakna antara hipertensi, diabetes melitus, dislipidemia, dan obesitas terhadap kualitas hidup pasien HFpEF. Kesimpulan: Terdapat hubungan yang bermakna secara statistik antara usia, jenis kelamin, dan riwayat merokok dengan kualitas hidup pasien HFpEF. Tidak terdapat hubungan bermakna antara hipertensi, diabetes melitus, dan obesitas terhadap kualitas hidup pasien HFpEF.
Kata kunci: faktor risiko, kualitas hidup, gagal jantung kronik fraksi ejeksi terjaga, MLHF


Background: The prevalence of heart failure in Indonesian adults is 1.5%, at least half of which categorized as heart failure with preserved ejection fraction (HFpEF). Quality of life assessment plays an important role in the management of heart failure, one of the tools widely used is the Minnesota Living with Heart Failure (MLHF) questionnaire. In Indonesia, there is no data regarding risk factors that affect the quality of life of HFpEF patients. Objective: To determine the quality of life profile of HFpEF patients and the relationship between the risk factors (age, hypertension, DM, smoking, and obesity) on the quality of life of HFpEF patients. Methods: Cross-sectional study. Data were collected from adult HFpEF (based on echocardiography in the last 6 months) patients ( > 18 years old) who visited the Poliklinik Jantung Terpadu Rumah Sakit dr. Cipto Mangunkusumo from January 2022 to December 2023. Quality of life was measured using the MLHF questionnaire. Bivariate analysis was performed to find the relationship between risk factors (age, gender, hypertension, DM, smoking, and obesity) and patients' quality of life. Multivariate analysis was performed for hypertension, DM, gender, and age variables. Results: Out of 206 subjects, 72.33% of patients were dominant in the physical domain items, and 27.67% of patients were dominant in the emotional domain items. The majority of patients dominant in physical items had overall good quality of life. The majority of patients dominant in emotional items also had good quality of life. No significant relationship was found between the dominant domain item and the quality of life in HFpEF patients. There was no significant relationship between socio-demographic factors and risk factors for dominant domain items. There was a significant relationship between age (p=0.005), gender (p=0.001), and smoking history (p=0.001) with the quality of life in HFpEF patients. Adult patients had a poorer quality of life compared to elderly patients (OR= 0.33 [95% CI 0.17-0.66]). No significant relationship was found between hypertension, diabetes mellitus, dyslipidemia, and obesity with the quality of life in HFpEF patients. Conclusion: There is a statistically significant relationship between age, gender, and smoking history with the quality of life in HFpEF patients. There is no significant relationship between hypertension, diabetes mellitus, and obesity with the quality of life in HFpEF patients
Keywords: risk factor, quality of life, heart failure with preserved ejection fraction, MLHF