A Prospective Pilot Study Evaluating the Effect of Cardiac Rehabilitation on Health-Related Quality of Life in Chronic Heart Failure at Laquintinie Hospital, Cameroon

Abstract

Background: Heart failure (HF) significantly impairs health-related quality of life (HRQoL). The Chronic Heart Failure Health-Related Quality of Life Questionnaire (CHFQOLQ-20) assesses physical, cognitive, general health, and mental domains. Although cardiac rehabilitation (CR) is guideline-recommended, its efficacy in improving HRQoL in sub-Saharan African settings remains poorly documented. Methods: HF patients (NYHA I–III) at Laquintinie Hospital, Douala, completed at least 10 CR sessions. HRQoL was assessed using the CHFQOLQ-20 before and after the CR program. Self-confidence was measured via a 5-point Likert scale. Data was normally distributed and total and domain HRQoL scores were compared with paired t-tests, internal consistency via Cronbach’s alpha. NYHA and self-confidence transitions were analysed using McNemar test. Results: Ten patients were included. Mean total CHFQOLQ-20 score increased from 70.3 ± 11.2 to 87.7 ± 10.7 post-CR (p<0.001). All domains improved significantly: physical function (+13.3, 95% CI: 9.1–17.5, p<0.001), general health (+1.6, p=0.002), except cognitive function (p=0.137) and mental health (p=0.111) domains. Cronbach’s alpha confirmed excellent reliability (pre-CR: 0.83; post-CR: 0.93). NYHA class improved in 40% (McNemar, p=0.344) and self-confidence improved markedly: 60% of patients transitioned from low/moderate to high levels (McNemar-Bowker on 3×3 table, p=0.157), although these were nonsignificant. Conclusion: This pilot study demonstrates that structured CR significantly improves HRQoL in HF patients, with robust psychometric properties of the CHFQOLQ-20. The greatest gains in physical function align with enhanced functional capacity and hemodynamic adaptation. These findings support CR integration into HF management protocols in resourceconstrained settings, providing a scalable, evidence-based approach to patient-centered care in Cameroon.