Abstract

Chronic heart failure is characterized by impaired cardiac function, but the relationship between clinical indices and subjective perception is not clear. This study was undertaken to investigate the relationship between cardiac function, exercise capacity and clinical classification, and the health-related quality of life (HRQOL) in 91 outpatients with an left ventricular ejection fraction (LVEF) less than 40%. Exercise capacity was evaluated by the Specific Activity Scale, and HRQOL by the Medical Outcome Study Short Form 36. Exercise capacity and the cardiothoracic ratio were correlated with the HRQOL related to physical functioning, although the correlation between exercise capacity and mental health was not significant. LVEF was not related to HRQOL. Factor analysis revealed (1) LVEF was independent of physical functioning; (2) physical function and exercise capacity comprise a factor reflecting physical HRQOL; and (3) socio-emotional functioning is the third factor independent of LVEF and physical function. Physical and socio-mental HRQOL measurement included information independent of the widely used clinical indices such as LVEF and New York Heart Association classification. The evaluation of HRQOL should be included in the assessment of patient status.