Introduction: Heart failure significantly impairs quality of life, yet data on the patient experience, particularly from low- and middle-income countries like Bangladesh, are scarce. Understanding the key drivers of poor HRQoL is essential for developing effective, patient-centered management strategies. This study aimed to assess health-related quality of life (HRQoL) and identify its associated sociodemographic and clinical factors among patients with heart failure with reduced ejection fraction (HFrEF) in Bangladesh. Methods: We conducted a prospective, single-center, cross-sectional study at a tertiary care hospital in Dhaka. A total of 800 patients with a confirmed diagnosis of HFrEF were enrolled. HRQoL was measured using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Sociodemographic, clinical, biochemical, and echocardiographic data were collected. A multiple linear regression model was used to identify independent factors associated with HRQoL scores. Results: The mean total MLHFQ score was 46.12 ± 26.06, with 43.3% of patients reporting poor HRQoL. In the multivariable analysis, poorer HRQoL was significantly associated with older age, being single or wido
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