Heart failure (HF) affects nearly 5 million Americans with a 5-year mortality rate of 50%. There is limited information on the relationship between patient-reported outcomes (e.g., utilities, quality of life) and New York Heart Association (NYHA) classification. OBJECTIVE: The objective of this study was to compare the correlation between utilities, QOL scores and NYHA class. METHODS: One hundred-two ambulatory HF patients provided utilities using the Rating Scale (RS), Time-Trade-Off (TTO) and Standard Gamble (SG) methods and QOL using the Medical Outcomes Study Short-Form 36 (SF-36) and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). NYHA class was extracted from patient charts. Data were analyzed using Pearson's Correlation Coefficients and ANCOVA. RESULTS: There were 11 Class I, 40 Class II, 34 Class III, and 17 Class IV HF patients. Mean age varied by class (47.5, 55.3, 51.8, and 55.0 years, respectively). More patients were female (62.0% overall), except Class I (36.4% female). Mean physical component summary scores (PCS) from the SF-36 were significantly different but mental component summary scores did not vary by NYHA class. Mean total MLHFQ scores were 20.2, 46.4, 61.9, and 80.8, respectively. Mean utility scores from the RS were 0.68, 0.60, 0.47, and 0.40; from the SG were 0.90, 0.85, 0.71, and 0.67; and from the TTO were 0.87, 0.88, 0.68, and 0.62, respectively. All means were adjusted for age and gender. The PCS, MLHFQ, and utility measures showed a consistent monotonic relationship with increasing HF class. Correlation between utility measures and the PCS and MLHFQ were highly significant (PCS r=0.30 to 0.47; and MLHFQ r=-0.53 to -0.33 for the RS, SG, and TTO; p <0.001). CONCLUSIONS: Results support prior belief that patient-reported outcomes worsen with HF progression. QOL and utility measures may assist clinicians quantifying the impact of HF on patients' well-being.