[Quality of life: a parameter to be taken into account, but how?]

The treatment of cardiac failure aims to improve the duration and quality of life of patients. This latter parameter is all the more important as the effects of treatment on longevity are relatively weak. However, it is difficult to assess: there is no universally recognised definition and the choice of criteria to take into consideration is very subjective. The different questionnaires of quality of life attempt to be reproducible, sensitive (that is to say capable of determining the effect of a treatment with accuracy), and valid (that is to say measuring that which they are designed to measured). However, the absence of reference values also makes their evaluation difficult. In addition, their use in populations different to that in which they were elaborated raises other problems. Criteria of substitution may be proposed, such as number of hospital admissions, functional tolerance, which are easier to quantify but which only reflect one of the aspects of quality of life. Although the importance of "quality of life" is increasingly recognised and this parameter is increasingly better studied, the quality of its appreciation makes it, as yet, premature for posing therapeutic indications such as circulatory assistance. On the other hand, it is essential to try to recognise the patients most affected by the constraints of their treatment.