Validation of the Heart QoL Health-Related Quality of Life Questionnaire in Patients with Chronic Ischemic Cardiomyopathy

Objective: The English HeartQoL health-related quality of life questionnaire has been validated in patients with angina and myocardial infarction living in the USA but not in patients with symptomatic heart failure. The factor structure, reliability, validity and responsiveness of the English HeartQoL was assessed in patients with heart failure due to chronic ischemic cardiomyopathy. Methods: A battery of five questionnaires, including the HeartQoL with a Global scale and Physical and Emotional subscales, was self-administered by 90 patients with chronic ischemic cardiomyopathy in Wisconsin, USA, and the HeartQoL factor structure, reliability and validity were assessed. Responsiveness was examined in a separate cohort of 20 patients undergoing cardiac resynchronization therapy. Results: The 2-factor HeartQoL structure was confirmed. Internal consistency reliability was strong with Cronbach’s α ≥0.88. Convergent validity correlations between similar HeartQoL and Minnesota Living with Heart Failure questionnaire (r=-0.81 to -0.82) and Short Form 36 Health Survey constructs (r=0.74 to 0.78) were strong with significantly weaker correlations between dissimilar constructs. Discriminative validity was confirmed on eight of the 10 a priori hypotheses. Over a 3-month period, responsiveness (minimal important difference and effect size) was confirmed on the HeartQoL Global scale and Physical subscale. Conclusion: The English HeartQoL is a reliable, valid and responsive health-related quality of life questionnaire in patients with symptomatic heart failure due to chronic ischemic cardiomyopathy. The English HeartQoL can be recommended as a core heart disease health-related quality of life questionnaire within and across patients with angina, myocardial infarction or heart failure.