Objective: To assess health related quality of life of patients with congestive heart failure; to compare
their quality of life with the previously characterised general population and in those with other chronic
diseases; and to correlate the different aspects of quality of life with relevant somatic variables.
Setting: University hospital.
Patients and design: A German version of the generic quality of life measure (SF-36) containing eight
dimensions was administered to 205 patients with congestive heart failure and systolic dysfunction.
Cardiopulmonary evaluation included assessment of New York Heart Association (NYHA) functional
class, left ventricular ejection fraction, peak oxygen uptake, and the distance covered during a standardised
six minute walk test.
Results: Quality of life significantly decreased with NYHA functional class (linear trend: p < 0.0001).
In NYHA class III, the scores of five of the eight quality of life domains were reduced to around one third
of those in the general population. The pattern of reduction was different in patients with chronic hepatitis
C and major depression, and similar in patients on chronic haemodialysis. Multiple regression
analysis showed that only the NYHA functional class was consistently and closely associated with all
quality of life scales. The six minute walk test and peak oxygen uptake added to the explanation of the
variance in only one of the eight quality of life domains (physical functioning). Left ventricular ejection
fraction, duration of disease, and age showed no clear association with quality of life.
Conclusions: In congestive heart failure, quality of life decreases as NYHA functional class worsens.
Though NYHA functional class was the most dominant predictor among the somatic variables studied,
the major determinants of reduced quality of life remain unknown.
Objective: To assess health related quality of life of patients with congestive heart failure; to comparetheir quality of life with the previously characterised general population and in those with other chronicdiseases; and to correlate the different aspects of quality of life with relevant somatic variables.Setting: University hospital.Patients and design: A German version of the generic quality of life measure (SF-36) containing eightdimensions was administered to 205 patients with congestive heart failure and systolic dysfunction.Cardiopulmonary evaluation included assessment of New York Heart Association (NYHA) functionalclass, left ventricular ejection fraction, peak oxygen uptake, and the distance covered during a standardisedsix minute walk test.Results: Quality of life significantly decreased with NYHA functional class (linear trend: p < 0.0001).In NYHA class III, the scores of five of the eight quality of life domains were reduced to around one thirdof those in the general population. The pattern of reduction was different in patients with chronic hepatitisC and major depression, and similar in patients on chronic haemodialysis. Multiple regressionanalysis showed that only the NYHA functional class was consistently and closely associated with allquality of life scales. The six minute walk test and peak oxygen uptake added to the explanation of thevariance in only one of the eight quality of life domains (physical functioning). Left ventricular ejectionfraction, duration of disease, and age showed no clear association with quality of life.Conclusions: In congestive heart failure, quality of life decreases as NYHA functional class worsens.Though NYHA functional class was the most dominant predictor among the somatic variables studied,the major determinants of reduced quality of life remain unknown.
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