Health‐related quality of life in left ventricular assist device‐supported patients

Abstract

AimsThis study aimed to evaluate the different health-related quality of life (HR-QoL) aspects in patients with both shortterm and long-term duration LVAD support at pre-specified time intervals. Methods and resultsWe performed a single-centre HR-QoL analysis of short-term and long-term LVAD-supported patients using the short version of the Kansas City Cardiomyopathy Questionnaire (KCCQ-12) and the Changes in Sexual Functioning Questionnaire along with a survey to evaluate patients' social and driving routines. Data were collected at baseline and at 6 or 12 month follow-up. Included were 46 patients with a median time from LVAD implantation of 1.1 [inter-quartile range (IQR) 0.5, 2.6] years. The median KCCQ-12 summary score was 56 (IQR 29, 74) with most favourable scores in the symptom frequency domain [75 (IQR 50, 92)] and worse scores in the physical limitation [42 (IQR 25, 75)] and QoL [44 (IQR 25, 75)] domains. No significant changes were apparent during study follow-up [KCCQ-12 summary score 56 (IQR 35, 80)], and no significant correlation between the KCCQ-12 summary score and ventricular assist device-support duration was detected (r = À0.036, P = 0.812). Sexual dysfunction was noted across all domains with a cumulative score of 31 (IQR 22, 42). Seventy-six per cent of patients resumed driving after LVAD implantation, and 43% of patients reported they socialize with family and friends more frequently since surgery. Conclusions Short-term and long-term LVAD-supported patients had impaired HR-QoL and sexual function at baseline and at follow-up yet reported an improvement in social interactions and independency. A broader spectrum of patient's reported HR-QoL measures should be integrated into the pre-LVAD implantation assessment and preparation.

Prognostic value of mitral regurgitation in patients undergoing left ventricular assist device deployment: A systematic review and meta‐analysis

“…There is a lack of data on patient-focused parameters such as quality-of-life and functional status, and systematic collection of this information is necessary to support this unique patient population effectively. 52 Future efforts should focus on reducing adverse outcomes in high-risk groups, 53 such as those with concomitant TR. 54 Zuberevich et al 8 suggested the potential benefits of operative TR resolution in cases where it accompanies severe levels of pre-operative MR.…”

Exercise Performance and Quality of Life of Left Ventricular Assist Device Patients After Long-Term Outpatient Cardiac Rehabilitation

“…[3][4][5][6] Currently, there is limited evidence on the long-term psychological status of LVAD patients, but data strongly support the negative impact of device-related complications and increased rehospitalizations on QoL in both short-and long-term studies. 7,8 Over the past decade, the number of destination therapy patients has increased substantially, 1 leading to cardiac rehabilitation (CR) programs aimed at improving impaired functional capacity and QoL in this specific patient population. Recently, this has involved a detailed investigation of peak oxygen uptake (V ˙o2peak ) in LVAD recipients, and it has been reported to be reduced even in patients with marked symptomatic improvement, 9 and low V ˙o2peak levels were highly predictive of death and HF hospitalization.…”

“…Quality of life (QoL) and physical activity improve immediately after LVAD implantation,2 but in most patients, exercise capacity remains markedly impaired 3–6. Currently, there is limited evidence on the long-term psychological status of LVAD patients, but data strongly support the negative impact of device-related complications and increased rehospitalizations on QoL in both short- and long-term studies 7,8…”

The ever‐changing field of mechanical circulatory support: new challenges at the advent of the ‘single device era’

“…Recently, the first experience with a fully implantable LVAD, the FIVAD system, was reported, 15 with obvious potential advantages in patient quality of life and obviating the risk of driveline infections. In addition, as has become clearer during the COVID‐19 pandemic, remote monitoring can reduce routine hospital visits, thereby improving quality of life of LVAD patients 16,17 . Innovation is also needed for more dedicated remote monitoring capabilities of LVAD systems, while respecting patient privacy safety, to improve early detection of pump malfunction and other patient‐device related adverse events.…”

“…In addition, as has become clearer during the COVID‐19 pandemic, remote monitoring can reduce routine hospital visits, thereby improving quality of life of LVAD patients. 16 , 17 Innovation is also needed for more dedicated remote monitoring capabilities of LVAD systems, while respecting patient privacy safety, to improve early detection of pump malfunction and other patient‐device related adverse events.…”