Comprehensive rehabilitation in chronic heart failure--better psycho-emotional status related to quality of life, brain natriuretic peptide concentrations, and clinical severity of disease.
OBJECTIVE
To evaluate the effects of a comprehensive outpatient rehabilitation program in chronic heart failure (CHF) on quality of life (QoL) in relation to emotional status and clinical severity of disease.


METHODS
25 patients with CHF were included in the 12-week comprehensive rehabilitation program. Initially, and at the end of the program, patients underwent graded cardio-pulmonary exercise testing, echocardiography, and determination of brain natriuretic peptide (BNP) concentration. In addition, they were assessed using: The Minnesota Living with Health Failure Questionnaire [MLHFQ]) for disease Specific QoL, the Hospital Anxiety and Depression Scale [HADS], and the State-Trait Anger Expression Inventory [STAXI]).


RESULTS
After 12 weeks of rehabilitation improvements in NYHA class, left ventricular ejection fraction (LVEF), and peak oxygen consumption were found, while mean BNP concentrations did not change. Disease specific QoL demonstrated improvements in physical component and the total score. Relative improvement of psycho-emotional scores correlated positively with relative improvement of disease specific QoL. In patients with LVEF > or =30% at baseline, changes in BNP concentration were positively associated with both anxiety and state anger, and with the emotional component score of MLHFQ.


CONCLUSIONS
Improvements in disease-specific QoL were closely associated to improvements of psycho-emotional status and clinical severity of CHF.
Laederach-Hofmann
Kurt
K
Department of General Internal Medicine, Psychiatric Out-Patient Clinic, Autonomic Laboratory, Inselspital, University of Berne, Switzerland. laederach@insel.ch
Roher-Gübeli
Rebecca
R
Messerli
Nadine
N
Meyer
Katharina
K
D001007:Anxiety / Q000523:psychology; D002908:Chronic Disease; D003863:Depression / Q000523:psychology; D004452:Echocardiography; D004644:Emotions; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000503:physiopathology; D006333:Heart Failure / Q000097:blood / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D007118:Immunoassay / Q000379:methods; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010101:Oxygen Consumption; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012720:Severity of Illness Index; D013318:Stroke Volume; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D020097:Natriuretic Peptide, Brain