Mautong Hans, Desai Aarti, Sharma Shriya, Ruiz Jose, Leoni Juan, Goswami Rohan
School of Health, Universidad Espíritu Santo-Ecuador, Samborondón 092301, Guayas, Ecuador.
John H. Stroger Jr. Hospital of Cook County, Chicago, IL 60612, USA.
Med Sci (Basel). 2025 Aug 19;13(3):146. doi: 10.3390/medsci13030146.
Patients with end-stage heart failure-related cardiogenic shock (HF-CS) are conclusively associated with a poor health-related quality of life (HRQL). Axillary mechanical circulatory support (aMCS), such as the Impella 5.5, is increasingly used in this population and may improve HRQL during hospitalization by providing enhanced left ventricular unloading. We aimed to assess changes in HRQL between admission and two weeks after Impella 5.5 placement in patients with HF-CS, using the Kansas City Cardiomyopathy Questionnaire (KCCQ). We conducted a prospective longitudinal analysis on patients with the Impella 5.5 between May 2023 and July 2023. Participants completed the condensed KCCQ-12 at admission and again two weeks post-implantation. Changes in the scores were evaluated using the Wilcoxon signed-rank test. Fifteen patients were enrolled. The median age was 59 years (50-63), and the median ejection fraction at implantation was 20% (15-30). On admission, most patients reported an overall HRQL of poor-to-fair (46.7%) according to the summary KCCQ-12 score. The median overall summary score increased significantly after Impella 5.5 support (50.52 vs. 28.13, = 0.005). Symptom frequency (70.83 vs. 43.75, = 0.009) and quality-of-life (50.00 vs. 12.50, = 0.023) domains improved significantly, while physical limitation showed a positive trend and social limitation remained unchanged. These HRQL improvements occurred alongside a significant shift toward lower SCAI shock stages, marked increases in cardiac output and cardiac index, and no escalation in vasoactive-inotropic requirements. Impella 5.5 support in HF-CS patients was associated with early and clinically meaningful improvements in HRQL, particularly in symptom frequency and quality of life, during the critical pre-transplant or recovery period. These findings suggest that the Impella 5.5 may provide both physiological and patient-perceived benefits in this high-risk population.
终末期心力衰竭相关的心源性休克（HF-CS）患者与健康相关生活质量（HRQL）较差密切相关。腋窝机械循环支持（aMCS），如Impella 5.5，在这一人群中的使用越来越多，并且通过增强左心室卸载可能会改善住院期间的HRQL。我们旨在使用堪萨斯城心肌病问卷（KCCQ）评估HF-CS患者在植入Impella 5.5前后两周内HRQL的变化。我们对2023年5月至2023年7月期间使用Impella 5.5的患者进行了一项前瞻性纵向分析。参与者在入院时和植入后两周再次完成了简化版的KCCQ-12。使用Wilcoxon符号秩检验评估分数变化。共纳入15名患者。中位年龄为59岁（50-63岁），植入时的中位射血分数为20%（15-30%）。入院时，根据KCCQ-12总分，大多数患者报告总体HRQL为差到中等（46.7%）。在Impella 5.5支持后，总体总分中位数显著增加（50.52对28.13，P = 0.005）。症状频率（70.83对43.75，P = 0.009）和生活质量（50.00对12.50，P = 0.023）领域显著改善，而身体限制呈积极趋势，社会限制保持不变。这些HRQL的改善与向较低SCAI休克阶段的显著转变、心输出量和心脏指数的显著增加以及血管活性药物需求未增加同时发生。在HF-CS患者中，Impella 5.5支持与在关键的移植前或恢复期HRQL的早期和具有临床意义的改善相关，特别是在症状频率和生活质量方面。这些发现表明，Impella 5.5可能在这一高危人群中提供生理和患者感知的益处。
