The patient perspective: Quality of life in advanced heart failure with frequent hospitalisations

Markku S Nieminen, Kenneth Dickstein, Cândida Fonseca, Jose Magaña Serrano, John Parissis, Francesco Fedele, Gerhard Wikström, Piergiuseppe Agostoni, Shaul Atar, Loant Baholli, Dulce Brito, Josep Comín Colet, István Édes, Juan E Gómez Mesa, Vojka Gorjup, Eduardo Herrera Garza, José R González Juanatey, Nenad Karanovic, Apostolos Karavidas, Igor KatsytadzeMatti Kivikko, Simon Matskeplishvili, Béla Merkely, Fabrizio Morandi, Angel Novoa, Fabrizio Oliva, Petr Ostadal, Antonio Pereira-Barretto, Piero Pollesello, Alain Rudiger, Robert H G Schwinger, Manfred Wieser, Igor Yavelov, Robert Zymliński

Research output: Journal article (peer-reviewed)Review article

115 Citations (Scopus)


End of life is an unfortunate but inevitable phase of the heart failure patients' journey. It is often preceded by a stage in the progression of heart failure defined as advanced heart failure, and characterised by poor quality of life and frequent hospitalisations. In clinical practice, the efficacy of treatments for advanced heart failure is often assessed by parameters such as clinical status, haemodynamics, neurohormonal status, and echo/MRI indices. From the patients' perspective, however, quality-of-life-related parameters, such as functional capacity, exercise performance, psychological status, and frequency of re-hospitalisations, are more significant. The effects of therapies and interventions on these parameters are, however, underrepresented in clinical trials targeted to assess advanced heart failure treatment efficacy, and data are overall scarce. This is possibly due to a non-universal definition of the quality-of-life-related endpoints, and to the difficult standardisation of the data collection. These uncertainties also lead to difficulties in handling trade-off decisions between quality of life and survival by patients, families and healthcare providers. A panel of 34 experts in the field of cardiology and intensive cardiac care from 21 countries around the world convened for reviewing the existing data on quality-of-life in patients with advanced heart failure, discussing and reaching a consensus on the validity and significance of quality-of-life assessment methods. Gaps in routine care and research, which should be addressed, were identified. Finally, published data on the effects of current i.v. vasoactive therapies such as inotropes, inodilators, and vasodilators on quality-of-life in advanced heart failure patients were analysed.

Original languageEnglish
Pages (from-to)256-264
Number of pages9
JournalInternational Journal of Cardiology
Publication statusPublished - 15 Jul 2015


  • Disease Progression
  • Heart Failure/mortality
  • Hospitalization/trends
  • Humans
  • Quality of Life/psychology
  • Survival Rate/trends
  • Treatment Outcome


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