Biermann Janine, Horack Martin, Kahlert Philipp, Schneider Steffen, Nickenig Georg, Zahn Ralf, Senges Jochen, Erbel Raimund, Wasem Jürgen, Neumann Till
Clinic of Cardiology, University Hospital Essen, Essen, Germany.
Institute for Health Care Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany.
Clin Res Cardiol. 2015 Oct;104(10):877-86. doi: 10.1007/s00392-015-0857-9. Epub 2015 Apr 21.
Transcatheter aortic valve implantation (TAVI) has proven a survival benefit in patients with severe symptomatic aortic stenosis (AS). Recently published data from the German TAVI registry reported a 1-year mortality rate of 19.9 %. However, there are limited data for the effect of TAVI on quality of life (QoL), especially in real life settings.
The German TAVI registry was launched to evaluate safety, effectiveness and QoL of TAVI in daily clinical routine. We analyzed health-related QoL, using the EQ-5D questionnaire.
Quality-of-life data were eligible for 460 patients who survived 12 months after TAVI (82.5 ± 6.0 years; 32.2 % men). At baseline, QoL (EQ-5D-index: 0.63 ± 0.26) was markedly depressed, but significantly improved 30 days and 12 months (0.67 ± 0.24; 0.70 ± 0.24; p < 0.0001) after TAVI procedure. In addition, the visual analogue health scale, recording the patient's self-rated health, significantly (p < 0.0001) increased from 42.0 ± 15.9 % at baseline to 57.0 ± 17.2 % (30 days) and 57.7 ± 19.6 % (12 months). A lower EQ-5D-index at baseline, a percutaneous transfemoral/transaxillar TAVI procedure, and indications other than frailty for TAVI were determinants for an improved QoL 1 year after TAVI.
Among patients with AS, TAVI resulted in meaningful improvements in QoL. This benefit was present shortly after TAVI and maintained for at least 1 year. Different gains in QoL regarding patient-subgroups and determinants for improved QoL could give further impetus for patient selection.
经导管主动脉瓣植入术（TAVI）已被证明对重度症状性主动脉瓣狭窄（AS）患者有生存益处。德国TAVI注册研究最近公布的数据显示，1年死亡率为19.9%。然而，关于TAVI对生活质量（QoL）影响的数据有限，尤其是在现实生活环境中。
德国TAVI注册研究旨在评估TAVI在日常临床实践中的安全性、有效性和生活质量。我们使用EQ-5D问卷分析了与健康相关的生活质量。
生活质量数据适用于460例TAVI术后存活12个月的患者（82.5±6.0岁；32.2%为男性）。基线时，生活质量（EQ-5D指数：0.63±0.26）明显下降，但在TAVI术后30天和12个月时显著改善（0.67±0.24；0.70±0.24；p<0.0001）。此外，记录患者自评健康状况的视觉模拟健康量表从基线时的42.0±15.9%显著（p<0.0001）提高到30天时的57.0±17.2%和12个月时的57.7±19.6%。基线时较低的EQ-5D指数、经皮股动脉/经腋动脉TAVI手术以及TAVI的非虚弱适应症是TAVI术后1年生活质量改善的决定因素。
在AS患者中，TAVI使生活质量得到了有意义的改善。这种益处出现在TAVI术后不久，并至少维持1年。不同患者亚组在生活质量方面的不同改善以及生活质量改善的决定因素可能会为患者选择提供进一步的推动力。
