traditional aims in the treatment of congestive heart failure are to relieve symptoms and to improve the
prognosis. Another major goal of health care is to maximise function in everyday life and to achieve the highest level of
quality of life within the specific limits imposed by the disease. Quality of life is a relatively new scientific measure to evaluate effectiveness of treatment strategies and the course of a disease.1–3 In congestive heart failure, several disease specific instruments—such as the Minnesota living with heart failure questionnaire4 — have proved useful in clinical studies.5–11 Disadvantages of these specific measures are that they are
difficult to compare across diseases and with controls in the
general population. Because they are designed to measure
specific aspects of a certain disease, unforeseen side effects of
treatment might go undetected (for a detailed review see
Guyatt12). Recently, quality of life was shown to be decreased
in patients with congestive heart failure in comparison with
the general population,13 14 using the medical outcome study
36 item short form health survey (SF-36), a validated, reliable,
and multidimensional generic measure of quality of life.15 16
However, the few studies which have investigated the relation
between quality of life and clinical variables (reflecting the
severity of disease) achieved inconclusive results.17–19 Our
major aims in the present study were therefore as follows: to
assess the extent of the impairment of quality of life in
patients with congestive heart failure in comparison with the
general population; to compare specific aspects of alterations
in quality of life in congestive heart failure with those in other
chronic diseases; and to examine the extent to which health
related quality of life is explained by various clinical indices,
namely New York Heart Association (NYHA) functional class,
peak oxygen uptake, the distance covered during a six minute
walk test, and the left ventricular ejection fraction.