Quality of life in heart failure: A review

Abstract

Heart failure (HF) is a major cause of morbidity and mortality worldwide. HF severity and mortality can be predicted by measurement of quality of life (QOL). Generic and disease-specific instruments for measurement of QOL have been shown to be effective in clinical settings and in research. QOL compares favorably with traditional calibrators of HF severity such as New York Heart Association (NYHA) class, left ventricular ejection fraction (LVEF), 6-min walk test (6MWT), and B-type natriuretic peptide levels. QOL measurement using domains such as social interaction, emotion, environmental interaction, sexual activity, and demographic characteristics, among others, can be used effectively in resource-limited environments, as well as adjunct to echocardiography and BNP. Lower QOL predicts early and more frequent HF hospitalization, depression, higher NYHA class, poor 6MWT, lower estimated glomerular filtration rate, and lower LVEF. Older age, lower socioeconomic status, longer duration of HF, and comorbidities correspond to lower QOL scores. Clinical trials incorporating QOL as primary and/or secondary end-point show improved QOL with the use of angiotensin receptor blockers, angiotensin-converting enzyme inhibitors, beta blockers, device therapies, such as implantable cardiac defibrillator, and exercise-based rehabilitation. The aim of this paper is to review information on QOL in HF.