left ventricular ejection fraction, and before the SF-36 was
administered. All variables were collected within a 48 hour
period.
Of the 239 patients who met the predetermined study criteria,
23 refused to participate or discontinued their participation,
and 11 failed to complete the SF-36. Complete datasets of
205 patients were thus available for statistical analysis.
Baseline assessment
Each patient’s history, clinical status, sociodemographic
variables, and the aetiology and duration of the heart failure
were assessed. Equilibrium radionuclide ventriculography was
performed with a multicrystal gamma camera (Orbiter;
Siemens, Erlangen, Germany) in the left anterior oblique view
to determine the left ventricular ejection fraction (for details
see Zugck20). Cardiopulmonary exercise testing was used to
determine the functional capacity of the subjects. Equipment
included a metabolic cart (Oxycon Alpha; Jaeger, Würzburg,
Germany), with an interfaced supine positioned bicycle
ergometer (Ergoline; Jaeger). Peak oxygen uptake was defined
as the maximum oxygen consumption measured during the
last 30 seconds of symptom limited exercise (for details, see
Zugck20). Submaximal exercise capacity was evaluated with
the six minute walk test21 within 24 hours, and at least four
hours before cardiopulmonary exercise (for details, see
Zugck20).
Quality of life assessment
Patients’ self assessment of health related quality of life was
measured by the German version of the SF-36.22 23 Evaluation
of the SF-36 was done by an investigator who was blinded to
the somatic variables. In brief, the SF-36 is a generic health
survey designed to assess aspects of health that are not
disease, treatment, or age specific. The SF-36 is a generic multidimensional
instrument consisting of eight multi-item components
representing physical functioning (PF; the extent to
which health limits physical activities, such as self care, walking