Assessment of Health Status of Patients with Symptomatic Heart Failure Receiving SGLT2 inhibitors using KCCQ12

Abstract Heart failure with reduced ejection fraction (HFrEF) remains a major public health challenge, leading to significant morbidity and mortality. The Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12) is a validated tool for assessing the health status of heart failure patients. Sodium-glucose cotransporter-2 (SGLT2) inhibitors have emerged as a novel therapeutic approach, improving cardiovascular outcomes. However, their impact on patient-reported quality of life needs further evaluation, especially in the Indian population. Objective: To evaluate the health status of patients with symptomatic HFrEF receiving SGLT2 inhibitors using KCCQ-12, focusing on improvements in physical limitations, symptom frequency, quality of life, and social limitations. Methods: A prospective case-control study was conducted at GSVM Medical College, Kanpur, over two years. A total of 84 patients with HFrEF were enrolled and assessed at three visits: baseline (Visit 1), after one month of standard care (Visit 2), and after six months of SGLT2 inhibitor therapy (Visit 3). KCCQ-12 domain scores were analysed using paired t-tests and Wilcoxon signed-rank tests. Results: Significant improvements were observed in all KCCQ-12 domains Domains V1 →V2 (%) V2 → V3 (%) Cumulative V1 → V3 (%) SS 31.1 17.5 60.4 SF 31.1 17.6 60.4 PL 31.1 17.6 60.4 SL 31.0 17.7 60.2 QL 31.1 17.6 60.4 Improvement Patterns Visit 1→2: Consistent ~31% improvement across all domains, reflecting strong initial treatment response. Visit 2→3: ~17.6% further gains, showing continued but slower progression. SF/PL equivalence: Identical trajectories confirm these domains measure overlapping constructs in this cohort. Total cumulative improvement from Visit 1 to 3 ranged 54-62% across domains, with paired t-tests confirming statistical significance (p<0.0001) for both intervals. This result correlating with improved functional and symptomatic status. Conclusion: SGLT2 inhibitors significantly enhance the quality of life, reduce symptom burden, and improve functional capacity in patients with HFrEF, as measured by KCCQ-12. These findings reinforce their role as an essential therapy in heart failure management.