{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T09:40:32Z","timestamp":1792489232418,"version":"4.5.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Population Health and Outcomes"],"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Although Kansas City Cardiomyopathy Questionnaire (KCCQ) domains independently quantify patients\u2019 symptoms, physical and social functioning, and quality of life, the interrelationships between domains (eg, symptoms impacting physical limitations) have not been described, nor whether these vary by age or sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Cross-sectional data from adult outpatients with heart failure and reduced ejection fraction from 2 multicenter US registries, the Change the Management of Patients With Heart Failure Registry (2015\u20132017) and Cardiovascular Outcomes Research Consortium (2001\u20132002), were used to fit recursive path analysis models relating age, sex, and KCCQ domain scores. The interrelationships of these factors were quantified using unstandardized and standardized effect estimates. Unstandardized effects denote the linear effect of the independent variable on the dependent variable in units specific to both variables. Standardized effects are unitless and are obtained by multiplying the unstandardized effect by the ratio of the standard deviations of the dependent and independent variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>The analytic cohorts included 4839 patients from the Change the Management of Patients With Heart Failure Registry (mean age, 66.1\u00b112.5 years, 29.3% women) and 547 patients from the Cardiovascular Outcomes Research Consortium (mean age, 66\u00b112 years, 23.8% women). Standardized effect estimates revealed moderate to strong interrelationships among the KCCQ domains (effect size range, 0.34\u20130.70). Symptoms were strongly associated with all other domains (range, 0.61\u20130.70). Quality of life was most associated with symptoms and social limitations (range: 0.48\u20130.60), and less so with physical limitations (effect size=0.34). By comparison, the associations of age and sex with KCCQ domains were much smaller (effect sizes &lt;0.2), and no interactions by age and sex were found.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>KCCQ domains were strongly interrelated, and these relationships did not differ appreciably by age or sex. These data enhance the interpretation of KCCQ domain scores in research and clinical practice; in particular, symptoms and social limitations may be key drivers of impaired quality of life in heart failure. Targeted interventions prioritizing these domains may most effectively improve patients\u2019 overall health status.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circoutcomes.126.013486","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T09:00:19Z","timestamp":1792486819000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Interrelationships Between Kansas City Cardiomyopathy Questionnaire Domains, Age, and Sex for Patients With Heart Failure: Findings From the CHAMP-HF and CORC Registries"],"prefix":"10.1161","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5906-5015","authenticated-orcid":true,"given":"Andrew A.","family":"Girard","sequence":"first","affiliation":[{"name":"University of Missouri\u2014Kansas City\u2019s Healthcare Institute for Innovations in Quality and Saint Luke\u2019s Mid America Heart Institute (A.A.G., P.G.J., Z.F., C.F.S., O.C.M., J.A.S., S.V.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7136-4464","authenticated-orcid":true,"given":"Philip G.","family":"Jones","sequence":"additional","affiliation":[{"name":"University of Missouri\u2014Kansas City\u2019s Healthcare Institute for Innovations in Quality and Saint Luke\u2019s Mid America Heart Institute (A.A.G., P.G.J., Z.F., C.F.S., O.C.M., J.A.S., S.V.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9190-195X","authenticated-orcid":true,"given":"Zhuxuan","family":"Fu","sequence":"additional","affiliation":[{"name":"University of Missouri\u2014Kansas City\u2019s Healthcare Institute for Innovations in Quality and Saint Luke\u2019s Mid America Heart Institute (A.A.G., P.G.J., Z.F., C.F.S., O.C.M., J.A.S., S.V.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3015-8912","authenticated-orcid":true,"suffix":"IV","given":"Charles F.","family":"Sherrod","sequence":"additional","affiliation":[{"name":"University of Missouri\u2014Kansas City\u2019s Healthcare Institute for Innovations in Quality and Saint Luke\u2019s Mid America Heart Institute (A.A.G., P.G.J., Z.F., C.F.S., O.C.M., J.A.S., S.V.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7072-5574","authenticated-orcid":true,"given":"Omar","family":"Cantu Martinez","sequence":"additional","affiliation":[{"name":"University of Missouri\u2014Kansas City\u2019s Healthcare Institute for Innovations in Quality and Saint Luke\u2019s Mid America Heart Institute (A.A.G., P.G.J., Z.F., C.F.S., O.C.M., J.A.S., S.V.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6912-7374","authenticated-orcid":true,"given":"Stephen J.","family":"Greene","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute and Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC (S.J.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1064-5008","authenticated-orcid":true,"given":"Justin M.","family":"Bachmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3192-8093","authenticated-orcid":true,"given":"Gregg C.","family":"Fonarow","sequence":"additional","affiliation":[{"name":"Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan UCLA Medical Center, Los Angeles, CA (G.C.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7683-4720","authenticated-orcid":true,"given":"Javed","family":"Butler","sequence":"additional","affiliation":[{"name":"Baylor Scott and White Research Institute, Dallas, TX (J.B.)."},{"name":"The University of Mississippi, Jackson (J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2839-2611","authenticated-orcid":true,"given":"John A.","family":"Spertus","sequence":"additional","affiliation":[{"name":"University of Missouri\u2014Kansas City\u2019s Healthcare Institute for Innovations in Quality and Saint Luke\u2019s Mid America Heart Institute (A.A.G., P.G.J., Z.F., C.F.S., O.C.M., J.A.S., S.V.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3367-0302","authenticated-orcid":true,"given":"Suzanne V.","family":"Arnold","sequence":"additional","affiliation":[{"name":"University of Missouri\u2014Kansas City\u2019s Healthcare Institute for Innovations in Quality and Saint Luke\u2019s Mid America Heart Institute (A.A.G., P.G.J., Z.F., C.F.S., O.C.M., J.A.S., S.V.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,10,20]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2024.09.019"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03520250075037"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-017-0818-2"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-005-3975-4"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2004.01.009"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.09.081"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/circheartfailure.119.006539"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2018.02.002"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2154"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2019.05.015"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/s2214-109x(23)00557-0"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-022-03276-y"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/circheartfailure.120.008284"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2005.02.004"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yjcafi.2025.07.003"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2021.0372"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2017.04.010"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.04.070"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.11.021"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.09.542"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/circoutcomes.115.001958"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2004.12.010"},{"key":"e_1_3_3_24_2","volume-title":"Statistical power analysis for the behavioral sciences","author":"Cohen J","year":"1988","unstructured":"Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Lawrence Erlbaum Associates; 1988","edition":"2"},{"key":"e_1_3_3_25_2","volume-title":"lavaan: latent variable analysis","author":"Rosseel Y","year":"2025","unstructured":"Rosseel Y, Jorgensen TD, Wilde LD, Oberski D, Byrnes J, Vanbrabant L, Savalei V, Merkle E, Hallquist M, Rhemtulla M, et al. lavaan: latent variable analysis. 2025. https:\/\/cran.r-project.org\/web\/packages\/lavaan\/index.html"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v048.i02"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v045.i03"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/9780470316696"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2004.12.001"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1093\/geronj\/38.3.349"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.2307\/2137238"}],"container-title":["Circulation: Population Health and Outcomes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCOUTCOMES.126.013486","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T09:00:20Z","timestamp":1792486820000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCOUTCOMES.126.013486"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,20]]},"references-count":30,"alternative-id":["10.1161\/CIRCOUTCOMES.126.013486"],"URL":"https:\/\/doi.org\/10.1161\/circoutcomes.126.013486","relation":{},"ISSN":["3068-563X"],"issn-type":[{"value":"3068-563X","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10,20]]},"assertion":[{"value":"2026-02-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e013486"}}