EVALUATION BY PATIENTS WITH HEART-FAILURE OF THE EFFECTS OF ENALAPRILCOMPARED WITH HYDRALAZINE PLUS ISOSORBIDE DINITRATE ON QUALITY-OF-LIFE - V-HEFT-II

Background. Two new questionnaires concerning the quality of life of p atients with heart failure were used in a randomized, controlled trial to determine if the patients' perceptions of the effects of enalapril on their daily activities and sense of well-being were different from those of a group treated with hydralazine and isosorbide dinitrate. M ethods and Results. The questionnaires were completed at baseline and at 3 months, 6 months, and subsequently every 6 months during follow-u p, which averaged 2.5 years (range, 0.5-5.7 years). Data from the ques tionnaires were reliable as indicated by correlation coefficients betw een repeated baseline scores of 0.88 and 0.87. Both treatment groups s howed a progressive deterioration in quality of life as measured by bo th questionnaires. The questionnaire scores of the two treatment group s were not significantly different at any follow-up visit. Furthermore , there were no differences between treatments among subgroups defined by baseline questionnaire scores, peak oxygen consumption, ejection f raction, previous vasodilator use, and plasma norepinephrine concentra tion. Conclusions. Although several factors may limit the generalizati on of these results, the lack of a difference with regard to patients' quality of life is an important consideration for the evaluation of t he relative therapeutic efficacy of these vasodilators.