The validation of a new quality of life questionnaire for patients with congestive heart failure–an extension of the Cardiac Health Profile

Figures & data

Table I.  Classification of cardiovascular disability according to the New York Heart Associations functional classification in the Cardiac Health Profile.

NYHA I:	Ordinary physical activity does not cause undue fatigue, palpitation or dyspnea.
NYHA II:	I am comfortable at rest. Ordinary physical activity results in fatigue, palpitation or dyspnea.
NYHA III A:	I am comfortable at rest. Less than ordinary physical activity (such as stair climbing) causes fatigue, palpitation or dyspnea.
NYHA III B:	I am comfortable at rest. Very slight physical activity (such as dressing yourself or washing up) causes fatigue, palpitation or dyspnea.
NYHA IV:	I am unable to carry on any physical activity without discomfort. Fatigue, palpitation or dyspnea may be present at rest.

NYHA: New York Heart Association.

Table II.  Questions in the CHPchf

1	Are you often tired?
2	Do your feet or calves swell?
3	Do you get out of breath easily?
4	Are your legs often tired?
5	Do you sometimes fear dying?
6	Do you have a good appetite?
7	Has your heart problem affected your outlook on life?
8	Are you at any time affected by a feeling of pressure in your chest?
9	Is your heart problem more of a difficulty with varying weather, such as cold or windy weather?
10	Are you easily tired in the afternoon?

Figure 1.  Frequency distribution for Global Mean Score in the CHPchf. CHPchf: Cardiac Health Profile congestive heart failure, GMS: Global mean score, n: number.

Figure 2.  Frequency distribution for total sum score in the Minnesota Living with Heart Failure Questionnaire. n: number, MLHFQ: Minnesota Living With Heart Failure Questionnaire.

Figure 3.  Correlation between the Global Mean Score of the CHPchf and the total sum score of MLHFQ. GMS: Global Mean Score, MLHFQ: Minnesota Living With Heart Failure Questionnaire.

Table III.  Characteristics of patient population (n = 83).

Age (years, SD)	61±14
Gender (%)
Female	20
Male	80
Clinical history (%)
Ischemic heart disease	44
- verified by angiogram	25
- myocardial infarction	36
Hypertension	20
Diabetes	6
Valvular heart disease	23
Cardiomyopathy	42
Other	6
Left ventricular ejection fraction (10)^* (%, SD)	30±14
Maximal work load on exercise test (22) (Watt, SD)	109±41
Boston heart failure score (10) (M, SD)	6.2±3.3
NYHA class (%)
I	6
II	24
IIIA	35
IIIB	21
IV	13
Present level of treatment (%)
Outpatient clinic	59
Cardiology ward	6
Transplantation ward	34
Presence of angina pectoris (%)	15
CCS II	64
CCS III	36

*: missing data, CCS: Canadian Cardiovascular Society, M: Mean, NYHA: New York Heart Association, SD: Standard deviation.

Table IV.  Descriptive data for each item in CHPchf.

Item	n (%)	Mean	SD	SEM	Correlation with total
1	79 (95)	54.9	28.1	3.1	0.86
2	80 (96)	31.3	34.1	3.8	0.64
3	81 (98)	63.3	27.7	3.1	0.77
4	81 (98)	42.6	29.4	3.3	0.62
5	82 (99)	19.4	21.4	2.4	0.42
6	82 (99)	29.3	28.3	3.1	0.53
7	82 (99)	67.7	29.7	3.3	0.77
8	82 (99)	36.5	31.7	3.5	0.68
9	79 (95)	43.3	36.6	4.1	0.55
10	80 (96)	55.4	28.6	3.2	0.65
GMS	83 (100)	44.4	20.3	2.2	–

GMS: global mean score, n and%: response frequency, SD: standard deviation, SEM: standard error of mean.

Table V.  Correlation between GMS for CHPchf with GMS for the generic part of the CHP and clinical variables.

Variable	r-value	F-value	p
Global Mean Score
CHP, generic part	0.74	94.5	<0.0001
Left ventricular ejection fraction	0.09	0.6	n.s.
Boston Heart Failure Score	0.43	16	<0.001
Max work load on ergometer bicycle	0.44	4.8	<0.05
NYHA classification	0.48	3.9	<0.01

CHP: Cardiac Health Profile, NYHA: New York Heart Association.

Figure 4.  Global Mean Score in CHPchf in relation to NYHA class. CHPchf: Cardiac Health Profile congestive heart failure, GMS: Global Mean Score, NYHA: New York Heart Association.