Quality of life and survival in patients with heart failure

Eur J Heart Fail. 2013 Jan;15(1):94-102. doi: 10.1093/eurjhf/hfs148. Epub 2012 Sep 18.


Aims: 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.

Methods and results: 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) 1.02-1.14] and general health (HR 1.08, 95% CI 1.01-1.16) dimensions of the RAND36. Patients with low scores on these dimensions were more likely to be in New York Heart Association class III-IV, diagnosed with co-morbidities, have suffered longer from HF, have lower estimated glomerular filtration rates, and have fewer beta-blocker prescriptions.

Conclusion: Quality of life was independently related to survival in a cohort of hospitalized patients with HF.

Trial registration: NCT 98675639.

Trial registration: ClinicalTrials.gov NCT98675639.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Female
  • Follow-Up Studies
  • Heart Failure / mortality*
  • Heart Failure / physiopathology
  • Heart Failure / psychology*
  • Humans
  • Male
  • Netherlands / epidemiology
  • Prospective Studies
  • Quality of Life*
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Survival Rate / trends
  • Time Factors

Associated data

  • ClinicalTrials.gov/NCT98675639