[Heart failure and instruments for measuring quality of life].

Heart failure is one of the most frequent and deadly diseases that clinicians have to deal with in clinical practice.1 Between 1% and 2% of the population aged over 40 have heart failure and rises to 10% in those over 60-70 years old. Heart failure is also the most rapidly increasing cardiac disease.2 It is the third leading cause of cardiovascular death in Spain, behind ischemic heart disease and stroke.2 In 2005, heart failure was responsible for 4% of all deaths in males and for 10% of all deaths due to cardiovascular disease. In women, the corresponding percentages were 8% and 18%.2,3 Recorded mortality for heart failure may nevertheless underestimate the disease’s true impact on mortality, because it is the final stage of many illnesses affecting the heart. For example, when heart failure is due to ischemic heart disease or a hypertensive disease, the death certificate would record the death as being the result of those diseases and not of heart failure. The increase in the prevalence of heart failure and the poor prognosis associated with the disease have driven research into its impact on health-related quality of life (HRQL).4 In fact, heart failure is one of the most important chronic diseases affecting HRQL,5 and although several clinical indicators are used to monitor evolution in patients’ functional status (for example, the New York Heart Association—NYHA—classification system),6 changes in patient perceptions of their health status may not be perceptible to the clinician. This another reason behind the increasing use of self-reported HRQL as an additional source of information about patients’ health status.7 In fact, many patients with advanced heart failure Heart Failure and Instruments for Measuring Quality of Life