Patient-reported health status and mortality across heart failure phenotypes: The modifying role of atrial fibrillation

We read the report by Molenda et al. [1] from the HEart failuRe ObsErvational Study (HEROES) registry with interest.The authors assessed health-related quality of life using Kansas City Cardiomyopathy Questionnaire-12 Summary Score (KCCQ-12 SS) and demonstrated a clinically important difference by atrial fibrillation (AF) status: patients without AF had a higher median KCCQ-12 SS of 56.3 (34.4-78.1)compared with 42.2 (24.0-64.3) in those with AF (P <0.001) [1].The key message is that patient-reported health status carries prognostic information, but the strength of this signal varies by phenotype.In the overall population, a 10-unit decrement in KCCQ-12 SS was associated with higher mortality in the less adjusted model Update underscores rapid optimization of guideline-directed therapy and patient-centered assessment, making KCCQ-guided escalation particularly relevant [5].