['One-third of patients with heart failure (HF) experience depressive symptoms that adversely affect health-related quality of life (HRQOL). We aimed to describe depressive symptom trajectory and determine whether a change in depressive symptoms predicts subsequent HRQOL.', 'The sample consisted of 256 inpatients and outpatients with HF. Depressive symptoms were measured at baseline and 3 or 6 months with the Patient Health Questionnaire (PHQ-9). The Minnesota Living with HF Questionnaire was used to assess HRQOL at baseline, 3 to 6 months, and 1 year. Based on baseline and 3- to 6-month PHQ-9 scores, patients were categorized as depressive symptom-free (64%), depressive symptoms improved (15%), depressive symptoms developed (6%), or persistent depressive symptoms (15%). The groups differed in 1-year HRQOL levels (F\xa0= 36, P < .001); patients who were depressive symptom-free or whose depressive symptoms improved had better 1-year HRQOL than patients with persistent depressive symptoms (Tukey honestly significant difference, P < .01). Change in depressive symptoms was the strongest predictor of 1-year HRQOL (standardized β\xa0= .42, P < .001), after controlling for functional status, demographics, and clinical variables.'] Does depressive symptom trajectory predict 1-year health-related quality of life in patients with heart failure?