Quality of life of advanced chronic heart failure: medical care, mechanical circulatory support and transplantation

Akan Emin, Chris A Rogers, Nicholas R Banner

Research output: Contribution to journalArticle (Academic Journal)peer-review

32 Citations (Scopus)
230 Downloads (Pure)

Abstract

OBJECTIVES Advanced chronic heart failure (ACHF) is progressive with poor prognosis and quality of life (QoL). Heart transplantation (HTx) is an effective treatment for ACHF, but is limited by scarcity of donor hearts. Left ventricular assist device (LVAD) support is a useful bridging therapy, and short- and medium-term outcomes have improved. We investigated QoL in patients assessed for HTx, awaiting HTx and after HTx.

METHODS We carried out a cross-sectional survey across four groups: Group 1—patients assessed for HTx, Group 2—patients listed for HTx on medical therapy, Group 3—patients supported with LVAD and Group 4—patients after HTx. Two questionnaires, the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the EuroQol dimensions (EQ-5D), were administered in all adult HTx centres in the UK. Scores calculated for the KCCQ and EQ-5D were compared.

RESULTS Three hundred and eighty-six patients completed questionnaires: 194 in Group 1, 28 in Group 2, 82 in Group 3 and 82 in Group 4. Patients after HTx reported the best QoL [KCCQ overall summary score: mean 73.0 (SD 27.2)]; patients with LVAD reported better QoL than those being assessed for HTx and those listed for HTx on medical therapy [overall summary score; LVAD: 52.6 (22.0), Listed on medical therapy: 33.3 (21.1), Assessment: 35.5 (21.5)]. Similarly, EQ-5D scores were highest in patients after HTx [HTx: mean 0.74 (0.27); LVAD: 0.58 (0.26), Listed on medical therapy: 0.44 (0.27), Assessment: 0.50 (SD 0.30)].

CONCLUSIONS Patients supported with LVAD had a significantly better QoL than those awaiting HTx without LVAD support, although HTx patients reported the best QoL.
Original languageEnglish
Pages (from-to)269-273
Number of pages5
JournalEuropean Journal of Cardio-Thoracic Surgery
Volume50
Issue number2
Early online date22 Apr 2016
DOIs
Publication statusPublished - Aug 2016

Keywords

  • Heart failure
  • Quality of life
  • Heart transplantation
  • Mechanical circulatory support
  • Extra corporeal membrane oxygenation
  • Ventricular assist device

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