Quality of life measured with EuroQol-five dimensions questionnaire predicts long-term mortality, response, and reverse remodelling in cardiac resynchronization therapy patients

Abstract

AimsThere are previous studies on quality of life (QoL) in cardiac resynchronization therapy (CRT) patients; however, there are no data with the short EuroQol-five dimensions (EQ-5D) questionnaire predicting outcomes. We aimed to assess the predictive role of baseline QoL and QoL change at 6 months after CRT with EQ-5D on 5-year mortality and response.Methods and resultsIn our prospective follow-up study, 130 heart failure (HF) patients undergoing CRT were enrolled. Clinical evaluation, echocardiography, and EQ-5D were performed at baseline and at 6 months of follow–up, continued to 5 years. Primary endpoint was all-cause mortality at 5 years. Secondary endpoints were (i) clinical response with at least one class improvement in New York Heart Association without HF hospitalization and (ii) reverse remodelling with 15% reduction in left ventricular end-systolic volume at 6 months. Fifty-four (41.5%) patients died during 5 years, 85 (65.3%) clinical responders were identified, and 63 patients (48.5%) had reverse remodelling. Baseline issues with mobility were associated with lower response [odds ratio (OR) 0.36, 95% confidence interval (CI) 0.16–0.84; P = 0.018]. Lack of reverse remodelling correlated with self-care issues at baseline (OR 0.10, 95% CI 0.01–0.94; P = 0.04). Furthermore, self-care difficulties [hazard ratio (HR) 2.39, 95% CI 1.17–4.86; P = 0.01) or more anxiety (HR 1.51, 95% CI 1.00–2.26; P = 0.04) predicted worse long-term survival. At 6 months, mobility (HR 3.95, 95% CI 1.89–8.20; P < 0.001), self-care (HR 7.69, 95% CI 2.23–25.9; P = 0.001), or ≥ 10% visual analogue scale (VAS) (HR 2.24, 95% CI 1.27–3.94; P = 0.005) improvement anticipated better survival at 5 years.ConclusionEuroQol-five dimension is a simple method assessing QoL in CRT population. Mobility issues at baseline are associated with lower clinical response, whereas self-care issues predict lack of reverse remodelling. Problems with mobility or anxiety before CRT and persistent issues with mobility, self-care, and VAS scale at 6 months predict adverse outcome.

Prognostic value of reverse remodelling criteria in heart failure with reduced or mid‐range ejection fraction

“…Forty‐two studies fulfilled the search criteria (Supporting Information, Table ) 5,7–47 . Two of them evaluated exclusively AR, 46,47 and two other studies assessed AR together with RR 8,9 .…”

Сhanges in quality of life in patients with congestive heart failure after cardiac resynchronization therapy

“…В исследовании Nagy K. V. с соавт. [12] было обнаружено, что если после проведения СРТ происходит улучшение таких параметров КЖ, как «мобильность» и «самообслуживание», то такие изменения ассоциированы с более благоприятным прогнозом в долгосрочном периоде (в течение 5 лет). Показатели КЖ «мобильность» и «самообслуживание» в исследовании Nagy K. V. с соавт.…”

“…В исследовании Nagy K. V. с соавт. было показано, что улучшение показателей КЖ в краткосрочном периоде у пациентов после СРТ способствовало более благоприятному про-гнозу в отдаленном периоде [12]. Аналогичные данные были получены Lenarczyk R. С соавт., улучшение КЖ через 6 месяцев было ассоциировано с лучшей выживаемостью через 2,5 года после операции [13].…”

Assessing health-related quality of life among patients with peripheral artery disease: A review of the literature and focus on patient-reported outcome measures

“…23 These assessments have been tested in diverse settings and delivered through platforms like smartphones and electronic tablets, creating an opportunity to capture information on symptoms pre- and post-treatment in a standardized fashion. Generic, non-disease-specific HRQoL measurement tools include the Short Form-12 (SF-12), 24 Short Form-36 (SF-36), 24 EuroQoL-5 Dimensions (EQ-5D), 25 Nottingham Health Profile, 26 and Sickness Impact Profile. 27 These instruments assess the impact of overall health (PAD as well as other comorbidities) on the functional status, health status, and HRQoL of individuals living with chronic illness.…”