Cardiology Research and Practice Acknowledgments The authors gratefully acknowledge the operating grant support provided by the Canadian Institutes of Health Research (CIHR) and personnel support of J. E. Tranmer and E. G. VanDenKerkhof provided by the Ontario Women’s Health Council and CIHR. They also acknowledge the important assistance provided by K. Bowes, Project Manager and A. Day, Senior Biostatistician from the Clinical Research Centre at Kingston General Hospital (Kingston, Ontario). References [1] S. J. Bennett, S. L. Baker, and G. A. Huster, “Quality of life in women with heart failure,” Health Care for Woman International, vol. 19, no. 3, pp. 217–229, 1998. [2] S. J. Bennett, S. M. Perkins, K. A. Lane, M. Deer, D. C. Brater, and M. D. Murray, “Social support and health-related quality of life in chronic heart failure patients,” Quality of Life Research, vol. 10, no. 8, pp. 671–682, 2001. [3] M. J. Rohrbaugh, V. Shoham, and J. C. Coyne, “Eﬀect of marital quality on eight-year survival of patients with heart failure,” American Journal of Cardiology, vol. 98, no. 8, pp. 1069–1072, 2006. [4] L. F. Berkman, L. Leo-Summers, and R. I. Horwitz, “Emo- tional support and survival after myocardial infarction: a prospective, population-based study of the elderly,” Annals of Internal Medicine, vol. 117, no. 12, pp. 1003–1009, 1992. [5] H. M. Krumholz, J. Butler, J. Miller et al., “Prognostic impor- tance of emotional support for elderly patients hospitalized with heart failure,” Circulation, vol. 97, no. 10, pp. 958–964, 1998. [6] D. Sorkin, K. S. Rook, and J. L. Lu, “Loneliness, lack of emotional support, lack of companionship, and the likelihood of having a heart condition in an elderly sample,” Annals of Behavioral Medicine, vol. 24, no. 4, pp. 290–298, 2002. [7] M. H. Chin and L. Goldman, “Correlates of early hospital readmission or death in patients with congestive heart failure,” American Journal of Cardiology, vol. 79, no. 12, pp. 1640–1644, 1997. [8] F. Mookadam and H. M. Arthur, “Social support and its relationship to morbidity and mortality after acute myocardial infarction: systematic overview,” Archives of Internal Medicine, vol. 164, no. 14, pp. 1514–1518, 2004. [9] S. L. Sayers, B. Riegel, S. Pawlowski, J. C. Coyne, and F. F. Samaha, “Social support and self-care of patients with heart failure,” Annals of Behavioral Medicine, vol. 35, no. 1, pp. 70– 79, 2008. [10] P. Williams, L. Barclay, and V. Schmied, “Deﬁning social support in context: a necessary step in improving research, intervention, and practice,” Qualitative Health Research, vol. 14, no. 7, pp. 942–960, 2004. [11] A. Rozanski, J. A. Blumenthal, K. W. Davidson, P. G. Saab, and L. Kubzansky, “The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice: the emerging ﬁeld of behavioral cardiology,” Journal of the American College of Cardiology, vol. 45, no. 5, pp. 637–651, 2005. [12] P. A. McKee, W. P. Castelli, P. M. McNamara, and W. B. Kannel, “The natural history of congestive heart failure: the Framingham study,” The New England Journal of Medicine, vol. 285, no. 26, pp. 1441–1446, 1971. 9 [13] C. P. Green, C. B. Porter, D. R. Bresnahan, and J. A. Spertus, “Development and evaluation of the Kansas City cardiomyopathy questionnaire: a new health status measure for heart failure,” Journal of the American College of Cardiology, vol. 35, no. 5, pp. 1245–1255, 2000. [14] J. S. Rumsfeld, E. Havranek, F. A. Masoudi et al., “Depressive symptoms are the strongest predictors of short-term declines in health status in patients with heart failure,” Journal of the American College of Cardiology, vol. 42, no. 10, pp. 1811–1817, 2003. [15] J. A. Spertus, P. G. Jones, J. Kim, and D. Globe, “Validity, relia- bility, and responsiveness of the Kansas City Cardiomyopathy Questionnaire in anemic heart failure patients,” Quality of Life Research, vol. 17, no. 2, pp. 291–298, 2008. [16] J. Myers, N. Zaheer, S. Quaglietti, R. Madhavan, V. Froelicher, and P. Heidenreich, “Association of functional and health status measures in heart failure,” Journal of Cardiac Failure, vol. 12, no. 6, pp. 439–445, 2006. [17] J. E. Ware Jr., M. Kosinski, and S. D. Keller, “A 12-item short- form health survey. Construction of scales and preliminary tests of reliability and validity,” Medical Care, vol. 34, no. 3, pp. 220–233, 1996. [18] J. E. Ware Jr., M. S. Bayliss, W. H. Rogers, M. Kosinski, and A. R. Tarlov, “Diﬀerences in 4-year health outcomes for elderly and poor, chronically III patients treated in HMO and fee- for-service systems: results from the medical outcomes study,” JAMA, vol. 276, no. 13, pp. 1039–1047, 1996. [19] M. Kosinski, S. Z. Zhao, S. Dedhiya, J. T. Osterhaus, and J. E. Ware Jr., “Determining minimally important changes in generic and disease-speciﬁc health-related quality of life questionnaires in clinical trials of rheumatoid arthritis,” Arthritis and Rheumatism, vol. 43, no. 7, pp. 1478–1487, 2000. [20] A. L. Stewart, S. Greenﬁeld, R. D. Hays et al., “Functional status and well-being of patients with chronic study. Results from the medical outcomes study,” JAMA, vol. 262, no. 7, pp. 907–913, 1989. [21] C. D. Sherbourne and A. L. Stewart, “The MOS social support survey,” Social Science and Medicine, vol. 32, no. 6, pp. 705– 714, 1991. [22] D. L. Groll, D. K. Heyland, M. Caeser, and J. G. Wright, “Assessment of long-term physical function in acute respira- tory distress syndrome (ARDS) patients: comparison of the Charlson Comorbidity Index and the Functional Comorbidity Index,” American Journal of Physical Medicine and Rehabilita- tion, vol. 85, no. 7, pp. 574–581, 2006. [23] D. L. Groll, T. To, C. Bombardier, and J. G. Wright, “The development of a comorbidity index with physical function as the outcome,” Journal of Clinical Epidemiology, vol. 58, no. 6, pp. 595–602, 2005. [24] W. M. Hopman, C. Berger, L. Joseph et al., “The natural progression of health-related quality of life: results of a ﬁve-year prospective study of SF-36 scores in a normative population,” Quality of Life Research, vol. 15, no. 3, pp. 527– 536, 2006. [25] A. Rosengren and P. Hauptman, “Women, men and heart failure: a review,” Heart Failure Monitor, vol. 6, no. 1, pp. 34– 40, 2008. [26] L. Pilote, K. Dasgupta, and V. Guru, “A comprehensive view of sex-speciﬁc issues related to cardiovascular disease,” CMAJ, vol. 176, no. 6, pp. S1–S44, 2007. [27] S. Heo, D. K. Moser, T. A. Lennie, B. Riegel, and M. L. Chung, “Gender diﬀerences in and factors related to self-care behaviors: a cross-sectional, correlational study of patients