Generic and disease-specific health-related quality of life in patients with chronic systolic heart failure: impact of depression

Clin Res Cardiol. 2013 Apr;102(4):269-78. doi: 10.1007/s00392-012-0531-4. Epub 2012 Dec 21.

Abstract

Aims: Heart failure is known to profoundly affect health-related quality of life (HRQoL). We aimed to describe both generic and disease-specific HRQoL in a large community-based sample of patients with systolic heart failure (SHF) and to identify important somatic and psychosocial correlates.

Methods and results: Seven hundred and two patients, 67 ± 12 years old, 71 % men, with distributions of New York Heart Association (NYHA) functional classes I/II/III/IV of 2/55/39/4 % were included in this cross-sectional analysis. Generic HRQoL was measured with the SF-36 health survey, disease-specific HRQoL with the Kansas City Cardiomyopathy Questionnaire, and depression with the self-reported Patient Health Questionnaire (PHQ-9). Both generic- and disease-specific HRQoL measurements indicated moderate to poor HRQoL. The KCCQ scores demonstrated higher sensitivity to the varying levels of heart failure severity as compared to the SF-36 scores. Patients with either a minor (15 %) or a major depression (24 %) reported significantly and substantially lower HRQoL (p < .001) than patients without depression did. In multivariable regression analyses, depression accounted for the largest part of the variance of both generic and specific HRQoL (12 and 36 %, respectively), whereas most biomedical variables had no or only a marginal influence.

Conclusion: Patients with SHF suffer from severe limitations of HRQoL. Depression was the most important correlate of both generic and disease-specific HRQoL.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Chronic Disease
  • Cross-Sectional Studies
  • Depression / epidemiology*
  • Depression / physiopathology
  • Female
  • Heart Failure, Systolic / physiopathology*
  • Heart Failure, Systolic / psychology
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Quality of Life*
  • Regression Analysis
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Surveys and Questionnaires