Quality of life and survival in patients with heart failure

To examine whether self-rated disease-specific and generic quality of life predicts long-term mortality, independent of brain natriuretic peptide (BNP) levels, and to explore factors related to low quality of life in a well-defined heart failure (HF) population. A cohort of 661 patients (62 male; age 71 years; left ventricular ejection fraction 34) was followed prospectively for 3 years. Quality of life questionnaires (Ladder of Life, RAND36, and Minnesota Living with Heart Failure Questionnaire) and BNP levels were assessed at discharge after a hospital admission for HF. Three-year mortality was 42. After adjustment for demographic variables, clinical variables, and BNP levels, poor quality of life scores predicted higher mortality; per 10 units on the physical functioning [hazard ratio (HR) 1.08, 95 confidence interval (CI) 1.021.14] and general health (HR 1.08, 95 CI 1.011.16) dimensions of the RAND36. Patients with low scores on these dimensions were more likely to be in New York Heart Association class IIIIV, diagnosed with co-morbidities, have suffered longer from HF, have lower estimated glomerular filtration rates, and have fewer beta-blocker prescriptions. Quality of life was independently related to survival in a cohort of hospitalized patients with HF. NCT 98675639.