Changes in disease-specific versus generic health status measures after left ventricular assist device implantation: Insights from INTERMACS

Michael E. Nassif, John A. Spertus, Philip G. Jones, Timothy J. Fendler, Larry A. Allen, Kathleen L Grady, Suzanne V. Arnold*

*Corresponding author for this work

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background Quantifying quality of life (QoL) after left ventricular assist device (LVAD) remains challenging. Heart failure (HF)-specific health status measures are ideal for assessing symptoms of HF; however, if patients’ QoL is limited by other factors, they may experience improved HF-specific QoL but no concurrent improvement in generic QoL. We sought to examine and predict discrepancies between disease-specific and generic QoL measures after LVAD. Methods We examined HF-specific and generic QoL with the Kansas City Cardiomyopathy Questionnaire (KCCQ) and EuroQol-5D Visual Analog Scale (VAS), respectively, among 1,888 patients with advanced heart failure who underwent LVAD implantation from 2012 to 2014 as part of the INTERMACS registry. Results Both measures showed substantial improvement, on average, at 6 months after LVAD, with mean changes of 32.7 ± 25.0 and 27.6 ± 27.4, respectively. Among the 1,539 patients (81.5%) with moderate/large improvement in KCCQ, 334 (21.7%) had discordant changes in generic QoL (i.e., VAS did not substantially increase despite improvement in KCCQ). In a multivariable logistic regression model, baseline VAS score was the strongest predictor of KCCQ-VAS discordance, whereas post-LVAD complications were not significant predictors of discordance. Conclusions Most patients have major improvements in both HF-specific and generic QoL after LVAD implantation, and discordance in these measures after LVAD is uncommon. When it did occur, discordance was primarily observed in patients who reported good generic QoL on the VAS before LVAD (despite substantial impairment due to congestive HF). These results support the continued use of HF-specific health status measures to monitor QoL before and after LVAD implantation.

Original languageEnglish (US)
Pages (from-to)1243-1249
Number of pages7
JournalJournal of Heart and Lung Transplantation
Volume36
Issue number11
DOIs
StatePublished - Nov 1 2017

Fingerprint

Heart-Assist Devices
Health Status
Quality of Life
Heart Failure
Visual Analog Scale
Cardiomyopathies
Logistic Models
Registries

Keywords

  • health status
  • heart failure
  • outcomes
  • quality of life
  • ventricular assist devices

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

Cite this

Nassif, Michael E. ; Spertus, John A. ; Jones, Philip G. ; Fendler, Timothy J. ; Allen, Larry A. ; Grady, Kathleen L ; Arnold, Suzanne V. / Changes in disease-specific versus generic health status measures after left ventricular assist device implantation : Insights from INTERMACS. In: Journal of Heart and Lung Transplantation. 2017 ; Vol. 36, No. 11. pp. 1243-1249.
@article{2ff7377498de4d1da855a08b40d95776,
title = "Changes in disease-specific versus generic health status measures after left ventricular assist device implantation: Insights from INTERMACS",
abstract = "Background Quantifying quality of life (QoL) after left ventricular assist device (LVAD) remains challenging. Heart failure (HF)-specific health status measures are ideal for assessing symptoms of HF; however, if patients’ QoL is limited by other factors, they may experience improved HF-specific QoL but no concurrent improvement in generic QoL. We sought to examine and predict discrepancies between disease-specific and generic QoL measures after LVAD. Methods We examined HF-specific and generic QoL with the Kansas City Cardiomyopathy Questionnaire (KCCQ) and EuroQol-5D Visual Analog Scale (VAS), respectively, among 1,888 patients with advanced heart failure who underwent LVAD implantation from 2012 to 2014 as part of the INTERMACS registry. Results Both measures showed substantial improvement, on average, at 6 months after LVAD, with mean changes of 32.7 ± 25.0 and 27.6 ± 27.4, respectively. Among the 1,539 patients (81.5{\%}) with moderate/large improvement in KCCQ, 334 (21.7{\%}) had discordant changes in generic QoL (i.e., VAS did not substantially increase despite improvement in KCCQ). In a multivariable logistic regression model, baseline VAS score was the strongest predictor of KCCQ-VAS discordance, whereas post-LVAD complications were not significant predictors of discordance. Conclusions Most patients have major improvements in both HF-specific and generic QoL after LVAD implantation, and discordance in these measures after LVAD is uncommon. When it did occur, discordance was primarily observed in patients who reported good generic QoL on the VAS before LVAD (despite substantial impairment due to congestive HF). These results support the continued use of HF-specific health status measures to monitor QoL before and after LVAD implantation.",
keywords = "health status, heart failure, outcomes, quality of life, ventricular assist devices",
author = "Nassif, {Michael E.} and Spertus, {John A.} and Jones, {Philip G.} and Fendler, {Timothy J.} and Allen, {Larry A.} and Grady, {Kathleen L} and Arnold, {Suzanne V.}",
year = "2017",
month = "11",
day = "1",
doi = "10.1016/j.healun.2017.05.023",
language = "English (US)",
volume = "36",
pages = "1243--1249",
journal = "Journal of Heart and Lung Transplantation",
issn = "1053-2498",
publisher = "Elsevier USA",
number = "11",

}

Changes in disease-specific versus generic health status measures after left ventricular assist device implantation : Insights from INTERMACS. / Nassif, Michael E.; Spertus, John A.; Jones, Philip G.; Fendler, Timothy J.; Allen, Larry A.; Grady, Kathleen L; Arnold, Suzanne V.

In: Journal of Heart and Lung Transplantation, Vol. 36, No. 11, 01.11.2017, p. 1243-1249.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Changes in disease-specific versus generic health status measures after left ventricular assist device implantation

T2 - Insights from INTERMACS

AU - Nassif, Michael E.

AU - Spertus, John A.

AU - Jones, Philip G.

AU - Fendler, Timothy J.

AU - Allen, Larry A.

AU - Grady, Kathleen L

AU - Arnold, Suzanne V.

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Background Quantifying quality of life (QoL) after left ventricular assist device (LVAD) remains challenging. Heart failure (HF)-specific health status measures are ideal for assessing symptoms of HF; however, if patients’ QoL is limited by other factors, they may experience improved HF-specific QoL but no concurrent improvement in generic QoL. We sought to examine and predict discrepancies between disease-specific and generic QoL measures after LVAD. Methods We examined HF-specific and generic QoL with the Kansas City Cardiomyopathy Questionnaire (KCCQ) and EuroQol-5D Visual Analog Scale (VAS), respectively, among 1,888 patients with advanced heart failure who underwent LVAD implantation from 2012 to 2014 as part of the INTERMACS registry. Results Both measures showed substantial improvement, on average, at 6 months after LVAD, with mean changes of 32.7 ± 25.0 and 27.6 ± 27.4, respectively. Among the 1,539 patients (81.5%) with moderate/large improvement in KCCQ, 334 (21.7%) had discordant changes in generic QoL (i.e., VAS did not substantially increase despite improvement in KCCQ). In a multivariable logistic regression model, baseline VAS score was the strongest predictor of KCCQ-VAS discordance, whereas post-LVAD complications were not significant predictors of discordance. Conclusions Most patients have major improvements in both HF-specific and generic QoL after LVAD implantation, and discordance in these measures after LVAD is uncommon. When it did occur, discordance was primarily observed in patients who reported good generic QoL on the VAS before LVAD (despite substantial impairment due to congestive HF). These results support the continued use of HF-specific health status measures to monitor QoL before and after LVAD implantation.

AB - Background Quantifying quality of life (QoL) after left ventricular assist device (LVAD) remains challenging. Heart failure (HF)-specific health status measures are ideal for assessing symptoms of HF; however, if patients’ QoL is limited by other factors, they may experience improved HF-specific QoL but no concurrent improvement in generic QoL. We sought to examine and predict discrepancies between disease-specific and generic QoL measures after LVAD. Methods We examined HF-specific and generic QoL with the Kansas City Cardiomyopathy Questionnaire (KCCQ) and EuroQol-5D Visual Analog Scale (VAS), respectively, among 1,888 patients with advanced heart failure who underwent LVAD implantation from 2012 to 2014 as part of the INTERMACS registry. Results Both measures showed substantial improvement, on average, at 6 months after LVAD, with mean changes of 32.7 ± 25.0 and 27.6 ± 27.4, respectively. Among the 1,539 patients (81.5%) with moderate/large improvement in KCCQ, 334 (21.7%) had discordant changes in generic QoL (i.e., VAS did not substantially increase despite improvement in KCCQ). In a multivariable logistic regression model, baseline VAS score was the strongest predictor of KCCQ-VAS discordance, whereas post-LVAD complications were not significant predictors of discordance. Conclusions Most patients have major improvements in both HF-specific and generic QoL after LVAD implantation, and discordance in these measures after LVAD is uncommon. When it did occur, discordance was primarily observed in patients who reported good generic QoL on the VAS before LVAD (despite substantial impairment due to congestive HF). These results support the continued use of HF-specific health status measures to monitor QoL before and after LVAD implantation.

KW - health status

KW - heart failure

KW - outcomes

KW - quality of life

KW - ventricular assist devices

UR - http://www.scopus.com/inward/record.url?scp=85021181593&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021181593&partnerID=8YFLogxK

U2 - 10.1016/j.healun.2017.05.023

DO - 10.1016/j.healun.2017.05.023

M3 - Article

C2 - 28662987

AN - SCOPUS:85021181593

VL - 36

SP - 1243

EP - 1249

JO - Journal of Heart and Lung Transplantation

JF - Journal of Heart and Lung Transplantation

SN - 1053-2498

IS - 11

ER -