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

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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.

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Acknowledgments

The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology. We are indebted to the patients who participated in the study. Further, we thank the heart failure specialist nurses S. Muck, M. Kirsch, E. Pfänder and E. Schupfner for support of patient acquisition and study logistics. We also thank Dr. C. Prettin and M. Hanke for excellent data and query management Funded by the German Ministry of Education and Research (BMBF, Berlin, project number 01GL0304) and by the German Competence Network Heart Failure (Berlin, BMBF project number 01GI0205).

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Correspondence to Marion Schowalter.

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Schowalter, M., Gelbrich, G., Störk, S. et al. Generic and disease-specific health-related quality of life in patients with chronic systolic heart failure: impact of depression. Clin Res Cardiol 102, 269–278 (2013). https://doi.org/10.1007/s00392-012-0531-4

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  • DOI: https://doi.org/10.1007/s00392-012-0531-4

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