title: Generic and disease-specific health-related quality of life in patients with chronic systolic heart failure: impact of depression.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  Patients with SHF suffer from severe limitations of HRQoL. Depression was the most important correlate of both generic and disease-specific HRQoL.
authors.affiliation: Department of Medical Psychology, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Klinikstr. 3, D 97070 Würzburg, Germany. schowalter@uni-wuerzburg.de
authors.forename: Marion
authors.initials: M
authors.lastname: Schowalter
authors.forename: Götz
authors.initials: G
authors.lastname: Gelbrich
authors.forename: Stefan
authors.initials: S
authors.lastname: Störk
authors.forename: Jan-Philip
authors.initials: JP
authors.lastname: Langguth
authors.forename: Caroline
authors.initials: C
authors.lastname: Morbach
authors.forename: Georg
authors.initials: G
authors.lastname: Ertl
authors.forename: Hermann
authors.initials: H
authors.lastname: Faller
authors.forename: Christiane E
authors.initials: CE
authors.lastname: Angermann
mesh_terms: D000368:Aged; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D054143:Heart Failure, Systolic / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011788:Quality of Life; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires