Effectiveness Of Long-term Weight Management Intervention On Prognosis In Patients With Chronic Congestive Heart Failure

Objective: The objective of the study was to evaluate the effectiveness of long-termweight management (WM) intervention on prognosis among patients with chroniccongestive heart failure (CHF).Methods: We performed a12-month randomized controlled trial. Patients who metour inclusion criteria were randomized into control group (N=71) and intervention group(N=71). Control group received usual care, while intervention group received usual careand WM intervention with scheduled telephone visits, focusing on education of dailyweight monitoring and actions to deal with sudden weight increase. Adherence to weightmonitoring, scores of WMQ, NYHA classifications, scores of HF-EMPS, CHF-relatedre-hospitalization, CHF-related mortality and scores of Minnesota Living with HeartFailure Questionnaire (MLHFQ) were compared at enrollment, at6month and12month.Results: At months6and12,47patients (71.21%) and40patients (60.61%)inintervention group reported optimal adherence to weight monitoring, respectively, and incontrol group,9patients (14.06%) and5patients(7.81%) reported optimal adherence,respectively, suggesting the intervention can greatly improve patients’ adherence to weightmonitoring (P＜0.001); Although at months12, patients with optimal adherence to weightmonitoring were less than those at months6, the difference was not statistically significant(P＞0.017). At months6and12, we observed both significantly higher scores of WMQ,including three subscales (weight monitoring, WM-knowledge, and WM-practice) inintervention group, compared with control group (P＜0.001). With-in comparison showedthat in control group, only WM-practice at6month improved significantly compared withenrollment (P＜0.001), while in intervention group, globally and all of the four subscalesimproved significantly at months6and12, respectively.At months6and12, NYHA classifications were both significantly improved in intervention group compared with control group（P＜0.001）. At months6, there was nosignificant difference in scores of total and each parameter of HF-EMPS between the twogroups（P＞0.05）. However, at months12, we observed lower scores of HF-EMPS,including left ventricular systolic function parameter、 pulmonary artery pressureparameter、ventricular remodeling parameter and total score, compared with controlgroup(P＜0.05).Patients in intervention group yielded significantly less CHF-related re-hospitalizationthan control group at months12(0.590±0.841vs.1.170±1.409, P=0.005), while there wasno significant difference at months6(0.270±0.570vs.0.500±0.836, P=0.074). Besides,there was no significant difference in CHF-related mortality at months12(1.49%vs.5.88%,P=0.366).At months6and months12, the global score of MLHFQ was both significantly lowerin intervention group compared with control group (P＜0.001), as well as the physicalscale and the emotion scale (P＜0.001). Patients in control group reported no significantdifference in physical scale between two time points（P＞0.017）,whose scores of emotionscale at months12showed significant difference compared with enrollment and months6（P＜0.017)and the global score at months6showed significant difference compared withenrollment and months12（P＜0.017）, respectively; but in intervention group, at months6and12, patients both reported lower scores of MLHFQ, including both physical andemotional component (P＜0.001, P＜0.001, P＜0.001)compared with enrollment.Conclusion: The long-term WM intervention could increase patients’ adherence toweight monitoring and WM ability, gradually improve patients’ cardiac function, andimprove patients’prognosis and CHF-related quality of life.