The Assessment of Quality of Life and Exercise Response in Patients with Chronic Cardiac Failure

Abstract

The symptom complex of chronic congestive heart failure is primarily composed of generalized fatigue and dyspnea, resulting in a limitation of exercise capability. In addition to the extensive morbidity associated with the disease, there is a growing appreciation of the excessive mortality that occurs in a population of patients with symptomatic heart failure. Thus, 2 fundamental goals of therapy for the patient with congestive heart failure are to improve the quality of life and to extend survival. Although measuring the impact of a therapy on mortality involves the evaluation of large numbers of patients followed for long periods of time, the endpoint of death is simple, unambiguous and without controversy. The same can not be said of the assessment of changes in quality of life. The purpose of this report will be to review the problems associated with our current efforts to objectively quantitate the effect of therapy on the signs, symptoms, exercise tolerance and general well-being of the patient with chronic cardiac failure.