[The concept of quality of life in cardiac failure]

Abstract

Chronic congestive heart failure is a common yet devastating syndrome and is a leading cause of morbidity and mortality in the industrialised countries. The incidence and prevalence of chronic congestive heart failure is increasing, placing a growing burden on the health care system. Despite many advances in treatment for heart disease, chronic heart failure is a terminal condition with a death rate as high as that for many malignant tumours. Patients suffering from chronic congestive heart failure report a poor quality of life because of physical symptoms, functional disability, emotional and economic burdens, frequent hospitalisations, and poor prognosis. In the context of heart failure, mortality risk (prognosis quoad vitam) can be measured using a variety of physiological variables; left ventricular (LV) dysfunction plays a primary role in the pathogenesis of congestive heart failure and correlates with prognosis, but a strong quantitative relation between exercise performance and indexes of LV function has not been demonstrated. This finding underscores the importance of psychosocial interventions in improving the quality of life and care outcomes for patients with heart failure. For this reason, questionnaires of quality of life, assessed by direct patient self-reports, have recently been imposed in cardiology, they have been used specially for evaluating most treatment of cardiac failure. The refinement of a definition of quality of life improved methods to study quality of life will contribute to a better understanding of this complex concept in heart failure patients.