Format

Send to

Choose Destination
See comment in PubMed Commons below
J Heart Lung Transplant. 2014 Apr;33(4):412-21. doi: 10.1016/j.healun.2013.10.017. Epub 2013 Oct 23.

Overall quality of life improves to similar levels after mechanical circulatory support regardless of severity of heart failure before implantation.

Author information

1
Division of Cardiac Surgery, Department of Surgery, Northwestern University, Chicago, Illinois. Electronic address: kgrady@nmh.org.
2
Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
3
Cardiovascular Division, Brigham and Women's Hospital, Boston, Massachusetts.
4
Departments of Epidemiology, Biostatistics, and Psychiatry, University of Pittsburgh School of Medicine and Medical Center, Pittsburgh, Pennsylvania.
5
Department of Biology, San Francisco State University, San Francisco, California.
6
Center for Circulatory Support, University of Michigan, Ann Arbor, Michigan.
7
the National Heart, Lung, and Blood Institute, Bethesda, Maryland.
8
Cleveland Clinic Foundation, Cleveland, Ohio.

Abstract

BACKGROUND:

The severity of pre-implantation heart failure may affect post-implantation health-related quality of life (HRQOL). The purpose of our study was to examine differences in HRQOL from before mechanical circulatory support (MCS) through 1 year after surgery by Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) patient profiles.

METHODS:

Data from 1,559 adults with advanced heart failure who received primary continuous-flow pumps between June 23, 2006, and March 31, 2010, and were enrolled in INTERMACS were analyzed. HRQOL data were collected using the EQ-5D-3L survey before implantation and at 3, 6, and 12 months after implantation. Statistical analyses included chi-square and t-tests, using all available data for each time period. Paired t-tests and sensitivity analyses were also conducted.

RESULTS:

HRQOL was poor before MCS implantation among patients with INTERMACS profiles 1 to 7 and significantly improved after MCS implantation for all profiles. Stratified by INTERMACS profile, problems within each of the 5 dimensions of HRQOL (i.e., mobility, self-care, usual activities, pain, and anxiety/depression) generally decreased from before to after implantation. By 6 months after implantation, patients with all INTERMACS profiles reported similar frequencies of problems for all HRQOL dimensions. Paired t-tests and sensitivity analyses supported almost all of our findings.

CONCLUSIONS:

HRQOL is poor among advanced heart failure patients with INTERMACS profiles 1 to 7 before MCS implantation and improves to similar levels for patients who remained on MCS 1 year after surgery. Patients have problems in HRQOL dimensions before and after MCS; however, the frequency of reporting problems decreases for all dimensions within most profiles across time.

KEYWORDS:

INTERMACS; continuous-flow pump; health-related quality of life; heart failure; mechanical circulatory support

PMID:
24360203
PMCID:
PMC3966941
DOI:
10.1016/j.healun.2013.10.017
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science Icon for PubMed Central
    Loading ...
    Support Center