Quality of life in patients with preserved and depressed left ventricular function

I. Lesman-Leegte

Department of Cardiology
Coach Study
University Hospital Groningen
PO Box 30.001
9700 RB Groningen, The Netherlands
E-mail address: g.a.t.lesman-leegte{at}thorax.azg.nl

Tiny Jaarsma*

Department of Cardiology
University Hospital Groningen
PO Box 30.001
9700 RB Groningen, The Netherlands
Tel: +31 50 361 3429
Fax: +31 50 361 4391
E-mail address: t.jaarsma{at}thorax.azg.nl

D.J. van Veldhuisen

Department of Cardiology
University Hospital Groningen
Groningen, The Netherlands

* Corresponding author

Until recently, heart failure (HF) with preserved left ventricular function (PLVF) seemed to be an underestimated problem. In the first instance it was assumed that morbidity and mortality among HF patients with PLVF was less serious compared with that among patients with a depressed left ventricular function. Recent insight however suggests that the picture is more grim than assumed.1 Yet little is known about the quality of life (QoL) of patients with diastolic HF, therefore Lenzen et al. should be commended for addressing this important topic.

The authors described a low QoL in 29% of patients with left ventricular systolic dysfunction (LVSD) and in 23% of patients with PLVF. They also found a difference in QoL between the two groups, suggesting that fewer patients with diastolic HF have a low QoL and therefore experience less impact of their HF on QoL.1

This is the first time such differences in QoL between patients with a preserved and depressed systolic function have been described. From previous research2,3 and our study4 it is known that not only patients with a depressed left ventricular function have impaired QoL but that the QoL of patients with a preserved left ventricle is as bad.

Although in previous studies therapeutic and prognostic differences were noted between patients with LVSD and PLVF, the symptoms and signs that patients exhibit seem often similar, having a large impact on their QoL. The results of such a low QoL in HF patients either with high or low LV function needs further discussion. Given the ageing and size of the population, and therefore an expected increase in the number of patients with PLVF, it is important to discern whether they have a worse prognosis and QoL than assumed. It is necessary that there is attention to QoL in these patients. Regardless of the LV function, HF patients need advising and counselling in managing their HF in order to improve their QoL.

References

  1. Lenzen MJ, Scholte op Reimer WJM, Boersma E. et al. Differences between patients with a preserved and a depressed left ventricular function: a report from the EuroHeart Failure Survey. Eur Heart J 2004;25:1214–1220.[Abstract/Free Full Text]
  2. Jaarsma T, Halfens R, Huijer-Abu Saad H et al. Quality of life in older patients with systolic and diastolic heart failure. Eur J Heart Fail 1999;1:151–160.[CrossRef][ISI][Medline]
  3. Philbin EF, Thomas A, Rocco A Jr. Systolic versus diastolic heart failure in community practice: clinical features, outcomes, and the use of angiotensin-converting enzyme inhibitors. Am J Med 2000;109:605–613.[CrossRef][ISI][Medline]
  4. Lesman-Leegte I, Jaarsma T, van der Wal MHL et al. Quality of life and depression are related in heart failure patients. Eur J Heart Fail 2004;3(Suppl.):42.




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