Comparison with the general population
Compared with the healthy general population, the congestive heart failure sample showed a global reduction in quality of life in all the SF-36 scales. All indices of quality of life decreased with NYHA functional class, the most pronounced loss of quality of life being observed in the domains of physical functioning, role function physical, and role function emotional. In apparently asymptomatic patients with left ventricular dysfunction, independently classified as NYHA functional class I, the SF-36 revealed mild but significant decreases in the scales representing somatic aspects and vitality. In NYHA classes II and III all aspects of quality of life were dramatically reduced, reflecting the severe impact of congestive heart failure on daily life, even though the patients were in a compensated stage and in an ambulatory setting. Comparison of the present study sample with a sample of patients with congestive heart failure of the medical outcome study 26 revealed a similar pattern of impairment. However, as the latter did not include objective functional variables such as the six minute walk test and peak oxygen uptake, a comparison between the two samples can only be limited.
physical health. These data are in accord with the findings of
some recent studies showing that a large proportion of
patients with congestive heart failure suffer from
depression.Thus the quality of life in patients in NYHA
class III is reduced not only physically but also mentally.
One could speculate that these results reflect the effects of
congestive heart failure on the central nervous system.
Changes in central neurohumoral regulation systems or
diminished central perfusion might impair cognitive capacity
and trigger a latent vulnerability to depressive disorders.