Balestroni Gianluigi, Omarini Giovanna, Omarini Pierangela, Pistono Massimo, Corrà Ugo, Gnemmi Marco, Giannuzzi Pantaleo
Monaldi Arch Chest Dis. 2014 Jun;82(2):55-60. doi: 10.4081/monaldi.2014.44.
Advanced heart failure is a challenging disease; the implantable Left Ventricular Assist Device (L-VAD) is becoming a good chance for relieving symptoms and prolong survival in most CHF patients. The emotional impact of L-VAD implantation is thought to be high but, at present, published data are scant about that. Aim of this study was to evaluate the modifications of perceived quality of life (QoL) in a group of patients recently treated with L-VAD implantation, admitted to a residential cardiac rehabilitation program, and to compare the results to those obtained in patients awaiting heart transplantation and recently transplanted.
We enrolled 66 patients (pts) with a recent implant of L-VAD, 51 with refractory heart failure awaiting heart transplantation (HT) and 55 recently treated with HT. On day two after admission, all patients underwent a complete psychometric assessment consisting in the compilation of: Minnesota Living with Heart Failure Questionnaire (MLHFQ). Beck Anxiety Inventory (BAI). Beck Depression Inventory-II (BDI-II).
L-VAD recipients had significantly higher scores at MLHFQ. Both the total score and the 2 subscales scores (respectively physical and emotional disturbances) were statistically significant when compared with post-transplant patients. Posttransplant pts had the lowest scores regarding anxiety symptoms, while the bearers of device had the highest ones. The same results were obtained for depression scores (BDI-II), both in total score and in the subscales (somatic symptoms and affective symptoms).
With an opening scoring, this study showed the development of more relevant psychological troubles in patients treated with L-VAD when compared to those awaiting for heart transplantation and those transplanted.
晚期心力衰竭是一种具有挑战性的疾病；可植入式左心室辅助装置（L-VAD）正成为大多数慢性心力衰竭患者缓解症状和延长生存期的良好机会。L-VAD植入的情感影响被认为很大，但目前关于这方面的已发表数据很少。本研究的目的是评估一组近期接受L-VAD植入并参加心脏康复住院项目的患者感知生活质量（QoL）的变化，并将结果与等待心脏移植和近期接受心脏移植的患者所获得的结果进行比较。
我们招募了66例近期植入L-VAD的患者、51例患有难治性心力衰竭并等待心脏移植（HT）的患者以及55例近期接受心脏移植治疗的患者。入院后第二天，所有患者均接受了全面的心理测评，包括填写：明尼苏达心力衰竭生活问卷（MLHFQ）、贝克焦虑量表（BAI）、贝克抑郁量表第二版（BDI-II）。
L-VAD接受者在MLHFQ上的得分显著更高。与移植后患者相比，总分以及两个子量表得分（分别为身体和情绪障碍）均具有统计学意义。移植后患者的焦虑症状得分最低，而装置携带者的得分最高。抑郁得分（BDI-II）在总分和子量表（躯体症状和情感症状）方面也得到了相同的结果。
通过开放式评分，本研究表明，与等待心脏移植和接受心脏移植的患者相比，接受L-VAD治疗的患者出现了更严重的心理问题。
