A research team led by Professor Sahmin Lee from the Division of Cardiology at Asan Medical Center analyzed echocardiographic results and quality of life data from 406 patients with heart failure.

The study found that improvements in diastolic function were associated with reduced physical and social limitations, leading to greater overall life satisfaction.

“Echocardiography, which has primarily been used to monitor treatment response, can also reflect patients’ subjective quality of life. This expands its clinical significance.”

▲ Professor Sahmin Lee from the Division of Cardiology at Asan Medical Center

Heart failure is a condition in which the heart loses its ability to pump sufficient blood throughout the body. Patients often experience shortness of breath and fatigue, which place significant limitations on daily life.

A research team led by Professor Sahmin Lee from the Division of Cardiology at Asan Medical Center analyzed echocardiographic findings and quality of life assessments in patients with heart failure. The study revealed that when diastolic function (the heart’s ability to receive blood) improved, patients experienced fewer physical and social limitations and reported greater life satisfaction.

The findings were recently published in the ‘European Journal of Heart Failure’ (impact factor 10.8), one of the world’s leading journals in the field of heart failure.

Professor Sahmin Lee and a research team from Brigham and Women’s Hospital, affiliated with Harvard Medical School, conducted a comparative analysis of echocardiographic parameters and quality of life scores before and after 24 weeks of medication in 406 patients with heart failure with reduced ejection fraction, defined as a left ventricular ejection fraction of 40 percent or lower.

Quality of life was assessed using the 12 item ‘Kansas City Cardiomyopathy Questionnaire’ (KCCQ-12). This survey comprehensively measures the frequency of symptoms such as shortness of breath, fatigue, and edema; limitations in daily physical activities due to heart failure; restrictions in social activities, leisure, and interpersonal relationships; and changes in overall life satisfaction caused by heart failure. Patients received medical therapy with sacubitril/valsartan or enalapril.

The analysis showed that improvements in left ventricular diastolic function were directly associated with proportional improvements in patients’ quality of life.

Specifically, for each increase in mitral annular velocity (e’), an echocardiographic indicator of diastolic function, patients experienced improvements of 2.4 to 2.7 points in physical activity limitation, 3.4 to 3.6 points in social limitation, and 2.3 to 2.4 points in life satisfaction.

The ratio of septal E to e’ (E/e’) reflects left ventricular filling pressure, with lower values indicating better diastolic relaxation. The study found that each decrease in the septal E/e’ ratio was associated with improvements of 2.8 points in physical activity limitation, 3.1 points in social limitation, and 3.3 points in life satisfaction. In contrast, when left atrial size increased due to impaired left ventricular relaxation, physical activity limitation worsened by 2.8 points, social limitation by 2.4 points, and life satisfaction by 2.0 points.

Left ventricular size and ejection fraction, which are indicators of systolic function, as well as right ventricular function, showed no significant association with changes in quality of life measures.

Professor Sahmin Lee from the Division of Cardiology at Asan Medical Center stated, “This study is meaningful in showing that echocardiography can serve not only as a diagnostic tool but also as a quantitative method to predict and improve patients’ quality of life. We will continue to pursue research that develops personalized treatment strategies through imaging based precision diagnostics.”

Meanwhile, the Asan Medical Center Heart Institute performs the largest number of echocardiographic examinations in Korea, supported by advanced high resolution 3D ultrasound technology and highly experienced specialists. Each year, the Asan Medical Center Heart Institute conducts about 70,000 detailed echocardiographic studies, contributing to patient centered care by linking quantitative analysis with clinical practice to ensure accurate diagnosis and tailored treatment strategies.