Abstract: Objective To analyzes the relationship between optimistic coping style, social support, nutrition evaluation and the quality of life of elderly patients with chronic heart failure(CHF). Methods The general condition, coping style, social support, nutritional status and quality of life of 312 elderly patients with chronic heart failure were investigated by the general situation questionnaire, the Chinese version of the Jalowiec coping scale, Social Support Rating Scale, and Mini-Nutrition Assessment Special for Heart Failure and Heart Failure and Minnesota Living with Heart Failure Questionnaire(MLHFQ). Results The average age of the 312 CHF patients in this study was(73.63±6.81) years old, and the quality of life scores was(40.80±11.94). The results of analysis of variance or t-test showed that the higher the age(t=5.400), the higher the education level(F=2.147), higher per capita monthly income(F=6.302), and lower cardiac function classification(F=9.530) have higher quality of life scores, and the differences are statistically significant(P<0.05). Among marital status, unmarried patients had the highest MLHFQ scores, and the differences were statistically significant(F=4.141, P<0.05). The results of multiple linear regression analysis showed that cardiac function classification(β=-0.159, P<0.001), optimism-coping style(β=0.144, P<0.01) and nutritional evaluation(β=0.417, P<0.001) were influencing factors of the life quality. The results of the mediation analysis showed that the nutritional evaluation of patients played a part of the mediation effect in the impact of optimism-coping and quality of life, with a mediation effect value of 0.063, accounting for 31.99% of the total effect. Conclusion The quality of life of elderly patients with CHF is at a low level, and the cardiac function classification, optimistic-coping style and nutritional evaluation are important influencing factors. Medical staff should formulate targeted nursing intervention measures, pay attention to the nutritional status and improve patients' optimistic coping level, to improve patients' quality of life.