Itzhaki Ben Zadok Osnat, Ben-Avraham Binyamin, Jaarsma Tiny, Shaul Aviv, Hammer Yoav, Barac Yaron D, Mats Israel, Eldar Orit, Abuhazira Miriam, Yaari Vicky, Gulobov Dmitry, Mulu Mastwal, Aravot Dan, Kornowski Ran, Ben-Gal Tuvia
Department of Cardiology, Rabin Medical Center, 39 Jabotinsky St, Petah Tikva, 49100, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
ESC Heart Fail. 2021 Jun;8(3):2036-2044. doi: 10.1002/ehf2.13282. Epub 2021 Mar 27.
This study aimed to evaluate the different health-related quality of life (HR-QoL) aspects in patients with both short-term and long-term duration LVAD support at pre-specified time intervals.
We 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 = -0.036, 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.
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.
本研究旨在评估接受短期和长期左心室辅助装置（LVAD）支持的患者在预先设定的时间间隔内不同的健康相关生活质量（HR-QoL）方面。
我们使用堪萨斯城心肌病问卷简版（KCCQ-12）和性功能变化问卷对短期和长期接受LVAD支持的患者进行了单中心HR-QoL分析，并进行了一项调查以评估患者的社交和驾驶习惯。在基线和6或12个月随访时收集数据。纳入46例患者，从LVAD植入到随访的中位时间为1.1[四分位间距（IQR）0.5，2.6]年。KCCQ-12总结评分中位数为56（IQR 29，74），在症状频率领域得分最有利[75（IQR 50，92）]，在身体限制[42（IQR 25，75）]和生活质量[44（IQR 25，75）]领域得分较差。在研究随访期间没有明显变化[KCCQ-12总结评分56（IQR 35，80）]，未检测到KCCQ-12总结评分与心室辅助装置支持持续时间之间存在显著相关性（r = -0.036，P = 0.812）。在所有领域均发现性功能障碍，累积评分为31（IQR 22，42）。76%的患者在LVAD植入后恢复驾驶，43%的患者报告自手术以来与家人和朋友的社交更频繁。
短期和长期接受LVAD支持的患者在基线和随访时HR-QoL和性功能受损，但报告社交互动和独立性有所改善。应将更广泛的患者报告的HR-QoL测量指标纳入LVAD植入前评估和准备中。
