Quality of Life Research

, Volume 22, Issue 7, pp 1603–1611 | Cite as

Health behaviors contribute to quality of life in patients with advanced heart failure independent of psychological and medical patient characteristics

  • Vina Bunyamin
  • Heike Spaderna
  • Gerdi Weidner



Little is known about the contribution of health behaviors to quality of life (QoL) in heart transplant candidates. We examined physical activity, dietary habits, psychological, and medical patient characteristics as correlates of QoL among patients enrolled in the multisite Waiting for a New Heart Study.


QoL (Minnesota Living with Heart Failure Questionnaire), demographic variables, psychological variables (e.g., depression, coping styles), and health behaviors (physical activity, dietary habits) were assessed in 318 patients (82 % male, 53 ± 11 years) at the time of wait-listing and analyzed in 312 patients (excluding six underweight patients). Eurotransplant provided BMI and medical variables to compute the Heart Failure Survival Score (HFSS). Hierarchical multiple regression models were used to assess the independent contribution of health behaviors to QoL.


The HFSS was unrelated to QoL. As expected, psychological characteristics (depression, anxiety, vigilant coping style) contributed to impaired QoL, accounting for 22.9, 35.9, and 12.9 % of the variance in total, emotional, and physical QoL, respectively. Physical inactivity further impaired QoL (total: 4.1 %, p < 0.001; physical: 7.4 %, p < 0.001). Dietary habits typically considered as unhealthy (i.e., infrequent consumption of fruits/vegetables/legumes; frequent intake of foods high in saturated fats) were related to enhanced physical QoL, but only among the overweight and obese patients.


Lifestyle interventions to modify negative emotions and to increase physical activity could help to improve QoL in heart transplant candidates, regardless of their disease severity. The role of eating habits in QoL among obese and overweight patients needs further exploration.


Quality of life Health behavior Heart transplantation Waiting list 



We are indebted to Annette Dangmann and Daniela Zahn for their assistance in data acquisition and preparation of data. We thank the hospitals and the patients for their participation. This work was supported by Alexander-von-Humboldt Foundation (GW); Eurotransplant International Foundation; German Academic Exchange Service (GW); German Research Foundation (DFG, Grant numbers SP 945/1-1, SP 945/1-3, SP945/1-4 to HS, MA 155/75-1 to GW); and Research funding Johannes Gutenberg-University Mainz (HS).

Conflict of interest

All authors declare that they have no financial interests and no conflict of interest. There are no relationships with industry.


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Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  1. 1.Department of PsychologyJohannes Gutenberg-UniversityMainzGermany
  2. 2.Department of BiologySan Francisco State UniversityTiburonUSA

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