European Heart Journal Advance Access originally published online on February 8, 2005
European Heart Journal 2005 26(5):526; doi:10.1093/eurheartj/ehi124
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Differences between patients with a preserved and a depressed left ventricular function: a report from the EuroHeart Failure Survey: reply
Department of Cardiology
Erasmus MC
P.O. Box 2040
3000 CA Rotterdam,
The Netherlands
E-mail address: m.lenzen{at}erasmusmc.nl
Department of Cardiology
Erasmus MC
P.O. Box 2040
3000 CA Rotterdam,
The Netherlands
Institut de Cardiologie
GH Pitié-Salpêtrière
47-83 Bld de l'Hopital
75013 Paris, France
E-mail address: michel.komajda{at}psl.ap-hop-paris.fr
We appreciate the comments by Dr Lesman and colleagues. They underline not only that symptoms and signs between patients with preserved and depressed left ventricular function often seem comparable, but also raise the important issue of poor quality of life (QoL) in heart failure patients.
In the two studies Dr Lesman and colleagues referred to, QoL was comparable between patients with preserved and depressed ventricular function, whereas in our study a higher proportion of patients with depressed ventricular function scored worse. It should be noted however that the involved studies used different instruments, and different time-points to measure QoL. We therefore have to be cautious when comparing the results. But our study and the studies referred to show that a sizeable proportion of heart failure patients with or without ventricular dysfunction were known to have an impaired QoL, irrespective of instrument or time-point used.
Another important issue regarding QoL refers to factors that affect the perceived QoL. It is important to note that not only the disease itself (i.e. high or low left ventricular function) and accompanying symptoms affect the QoL, but also an interaction of physical, social, and psychological factors.1 It is even suggested that depressive symptoms may have greater impact on QoL in heart failure patients than severity of cardiac dysfunction.2 Besides depression, anxiety, coping strategies, social isolation, lack of information or exclusion from management, age, and sex are known to contribute to the perceived QoL of heart failure patients.3,4
We welcome the suggestion that in all heart failure patients, irrespective of ventricular function, patients need advising and counselling in managing their heart failure in order to improve QoL. In addition to this we would like to stress that documentation of perceived QoL is important, but we also have to invest in programmes aiming to deal with this topic.
References
- Majani G, Pierobon A, Giardini A, Callegari S, Opasich C, Cobelli F, Tavazzi L. Relationship between psychological profile and cardiological variables in chronic heart failure. The role of patient subjectivity. Eur Heart J 1999;20:1579–1586.
[Abstract/Free Full Text] - Carels RA. The association between disease severity, functional status, depression and daily quality of life in congestive heart failure patients. Qual Life Res 2004;13:63–72.[CrossRef][Web of Science][Medline]
- Ward C. The quality of life in heart failure: just talking about it will not make it better. Eur J Heart Fail 2004;6:535–537.[Medline]
- Hou N, Chui MA, Eckert GJ, Oldridge NB, Murray MD, Bennett SJ. Relationship of age and sex to health-related quality of life in patients with heart failure. Am J Crit Care 2004;13:153–161.
[Abstract/Free Full Text]
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||