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Open Heart. 2019 Feb 27;6(1):e000932. doi: 10.1136/openhrt-2018-000932. eCollection 2019.

Factors associated with health-related quality of life among adults with tetralogy of Fallot.

Author information

1
Heart Centre and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
2
Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden.
3
Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden.
4
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
5
Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
6
Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.

Abstract

Background:

Due to improved care, the numbers of patients with tetralogy of Fallot (ToF) are increasing. However, long-term morbidity and need for reinterventions are concerns and also address issues of quality of life (QoL).

Methods:

Patients with ToF and valid EuroQol-5 dimensions questionnaire (EQ-5D) were identified in the national Swedish register on congenital heart disease. EQ-5Dindex was calculated and dichotomised into best possible health-related QoL (EQ-5Dindex=1) or differed from 1.

Results:

288 patients met the criteria and were analysed. Univariate logistic regression showed a positive association between New York Heart Association (NYHA) class I (OR 8.32, 95% CI 3.80 to 18.21), physical activity >3 h/week (OR 3.34, 95% CI 1.67 to 6.66) and a better right ventricular function (OR 2.56, 95% CI 1.09 to 6.02). A negative association between symptoms (OR 0.23, 95% CI 0.13 to 0.42), cardiovascular medication (OR 0.31, 95% CI 0.18 to 0.53), age (OR 0.97, 95% CI 0.96 to 0.99) and EQ-5Dindex was observed. In multivariate logistic regression, NYHA I (OR 7.28, 95% CI 3.29 to 16.12) and physical activity >3 h/week (OR 2.27, 95% CI 1.07 to 4.84) remained associated with best possible health-related QoL. Replacing NYHA with symptoms in the model yielded similar results.

Conclusion:

In this registry study, self-reported physical activity, staff-reported NYHA class and absence of symptoms were strongly associated with best possible health-related QoL measured by EQ-5D. Physical activity level is a potential target for intervention to improve QoL in this population but randomised trials are needed to test such a hypothesis.

KEYWORDS:

congenital heart disease; physical activity; quality of life; register; tetralogy of fallot

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