Sexual function in patients supported with left ventricular assist device and with heart transplant

Hasin, Tal; Jaarsma, Tiny; Murninkas, Daniel; Setareh-Shenas, Saman; Yaari, Vicky; Bar-Yosef, Simona; Medalion, Benjamin; Gerber, Yariv; Ben‐Gal, Tuvia

doi:10.1002/ehf2.12014

Cited by 21 publications

(20 citation statements)

References 22 publications

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“…51 In patients with advanced left heart failure who have left ventricular assist devices (LVADs), device-related issues frequently contribute to sexual dysfunction and SHRQoL, akin to our observations, and in one study the impact of LVADs on sexual health tracked with the development of depression, known to be common in PAH. [27][28][29] While we did not quantify anxiety and depression in this study, mental health is frequently impacted in individuals with chronic diseases characterized by equipment and physical challenges, 52,53 which suggests that these issues may need to be addressed concurrently in PAH. Given the fact that PAH treatments are challenging but reduce symptoms and prolong survival, it is plausible that treatment with parenteral therapy may negatively impact sexual health and patients' engagement in sexual behaviors, but not affect (or at least beneficially offset) other aspects of HRQoL.…”

Section: Scalementioning

confidence: 96%

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Sexual health and health‐related quality of life among women with pulmonary arterial hypertension

et al. 2018

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Pulmonary arterial hypertension (PAH) is characterized by progressive limitations in physical activity and health-related quality of life (HRQoL). HRQoL deficits may extend beyond the traditional domains of physical activity, psychological health, and emotional wellbeing to sexual health and function. Sexual HRQoL has not been studied in PAH, nor has the impact of PAH therapies themselves on sexual health and intimacy. In this initial investigation, we sought to explore HRQoL among women diagnosed with PAH and to determine if PAH treatment type (intravenous or subcutaneous prostanoids versus oral medications) was associated with levels of self-reported HRQoL assessed by validated measures for PAH-specific, general, and sexual HRQoL. We administered the emPHasis-10, Short Form (SF)-36, Female Sexual Dysfunction Scale-Revised (FSDS-R), and the Arizona Sexual Experience Scale (ASEX) to 35 women with self-reported World Health Organization Group 1 PAH at the 2016 Pulmonary Hypertension Association International Conference and Scientific Sessions. HRQoL instruments demonstrated excellent internal reliability. Women with PAH had high levels of sexual distress captured with the FSDS-R scale. The FSDS-R (but not ASEX) was significantly correlated to emPHasis-10 (r = 0.64, p < 0.01) and most SF-36 domains (r = − 0.36 to − 0.64, p < 0.05). Participants treated with intravenous or subcutaneous prostanoids had higher (worse) FSDS-R scores than those on oral therapies while ASEX, emPHasis-10, and SF-36 scores were similar across treatment types. Sexual HRQoL may impact overall quality of life in PAH and specific assessment of sexual health and functioning within intimate relationships may detect deficits in wellbeing not addressed by established HRQoL metrics. Further study to address all aspects of HRQoL in PAH is required.

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Section: Scalementioning

confidence: 96%

“… 24 – 26 Finally, anxiety and depression is common in PAH and it is conceivable that this may be driven in part by as yet unquantified effects on sexual relationships and feelings of intimacy. 27 – 29 …”

Section: Introductionmentioning

confidence: 99%

Sexual health and health‐related quality of life among women with pulmonary arterial hypertension

et al. 2018

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“…8 Sexual problems can be related to other HF treatment such as device therapy or heart transplantation. 24,25 In a small study of 31 patients, 29% left ventricular assist device (LVAD) patients and 71% heart transplant patients reported being content with sexual activity; however, satisfaction with sex life was lower in transplant patients compared with HTx patients (7.6 ± 3.1 for HTx on a visual analogue scale vs. 3.9 ± 4.0 for LVAD patients, P = 0.017). 24 In addition to HF symptoms, comorbidity, and HF treatment, several other factors such as psychological factors (depression, anxiety) can contribute to sexual problems.…”

Section: Prevalence Of Sexual Problems In Heart Failure Patientsmentioning

confidence: 99%

“…24,25 In a small study of 31 patients, 29% left ventricular assist device (LVAD) patients and 71% heart transplant patients reported being content with sexual activity; however, satisfaction with sex life was lower in transplant patients compared with HTx patients (7.6 ± 3.1 for HTx on a visual analogue scale vs. 3.9 ± 4.0 for LVAD patients, P = 0.017). 24 In addition to HF symptoms, comorbidity, and HF treatment, several other factors such as psychological factors (depression, anxiety) can contribute to sexual problems. 5 More general factors that are related to sexual function might be relevant to consider in the HF population as well, such as age, lifestyle, or problems in a relationship.…”

Section: Prevalence Of Sexual Problems In Heart Failure Patientsmentioning

confidence: 99%

Sexual function of patients with heart failure: facts and numbers

Jaarsma

2016

ESC Heart Failure

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Approximately 60% to 87% of patients with heart failure (HF) report sexual problems, and numbers as low as 31% of HF patients younger than 70 have normal sexual function. When compared with healthy elders, the amount of perceived sexual dysfunction might be similar (around 56%), but patients with HF are reporting more erectile dysfunction (ED) and also perceive that their HF symptoms (20%) or HF medication (10%) is the cause for their problems. The prevalence of ED is highly prevalent in men with cardiac disease and reported in up to 81% of cardiac patients, compared with 50% in the general older population. In total 25–76% of women with HF report sexual problems or concerns.The physical effort related to sexual activity in cardiac patients can be compared to mild to moderate physical activity. The related energy expenditure of sexual activity falls in the range of three to five metabolic units (METs), which can be compared to the energy needed to climb three flights of stairs, general housework, or gardening.Information about sexual activity is often overlooked by health care professionals treating HF patients. Advice and counselling about this subject are needed to decrease worries of patients and partners, avoid skipping medication because of fear for side effects, or prevent inappropriate use of potency enhancing drugs or herbs.

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“…These authors concluded that sexual dysfunction is prevalent in patients with LV assist device support and that it may be more prominent in these patients than after cardiac transplantation. In addition, they state that ‘problems limiting sexual function related to physiological, psychological, and equipment merit consideration during follow‐up’ . Lastly, Steinbeck et al have studied a first potential biomarker of skeletal muscle wasting, the C ‐terminal agrin fragment, in patients with HF …”

Section: Co‐morbidities and Heart Failurementioning

confidence: 99%

ESC Heart Failure: a new journal aims to broaden heart failure views

Haehling

Papp

Anker

2016

European J of Heart Fail

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Sexual function in patients supported with left ventricular assist device and with heart transplant

Abstract: Sexual dysfunction occurs in patients with LVAD support and may be more prominent than after HTx. Problems limiting sexual function related to physiological, psychological, and equipment merit consideration during follow-up.

Cited by 21 publications

References 22 publications

Sexual health and health‐related quality of life among women with pulmonary arterial hypertension

Sexual health and health‐related quality of life among women with pulmonary arterial hypertension

Sexual function of patients with heart failure: facts and numbers

ESC Heart Failure: a new journal aims to broaden heart failure views

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