Implant Strategy-Specific Changes in Symptoms in Response to Left Ventricular Assist Devices

Christopher S. Lee*, Jill M. Gelow, Christopher V. Chien, Shirin O. Hiatt, Julie T. Bidwell, Quin E. Denfeld, Kathleen L Grady, James O. Mudd

*Corresponding author for this work

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Although we know that the quality of life generally improves after left ventricular assist device (LVAD) implantation, we know little about how symptoms change in response to LVAD. Methods: The purpose of this study was to compare the changes in symptoms between bridge and destination therapy patients as part of a prospective cohort study. Physical (dyspnea and wake disturbances) and affective symptoms (depression and anxiety) were measured before LVAD and at 1, 3, and 6 months after LVAD. Multiphase growth modeling was used to capture the 2 major phases of change: Initial improvements between preimplant and 1 month after LVAD and subsequent improvements between 1 and 6 months after LVAD. Results: The sample included 64 bridge and 22 destination therapy patients as the preimplant strategy. Destination patients had worse preimplant dyspnea and wake disturbances, and they experienced greater initial improvements in these symptoms compared with bridge patients (all P <.05); subsequent change in both symptoms were similar between groups (both P >.05). Destination patients had worse preimplant depression (P =.042) but experienced similar initial and subsequent improvements in depression in response to LVAD compared with bridge patients (both P >.05). Destination patients had similar preimplant anxiety (P =.279) but experienced less initial and greater subsequent improvements in anxiety after LVAD compared with bridge patients (both P <.05). Conclusion: There are many differences in the magnitude and timing of change in symptom responses to LVAD between bridge and destination therapy patients. Detailed information on changes in specific symptoms may better inform shared decision-making regarding LVAD.

Original languageEnglish (US)
Pages (from-to)144-151
Number of pages8
JournalJournal of Cardiovascular Nursing
Volume33
Issue number2
DOIs
StatePublished - Mar 1 2018

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Heart-Assist Devices
Anxiety
Depression
Dyspnea
Affective Symptoms
Decision Making
Cohort Studies
Therapeutics
Quality of Life
Prospective Studies

Keywords

  • Heart-Assist devices
  • heart failure
  • quality of life
  • symptom assessment

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

Lee, C. S., Gelow, J. M., Chien, C. V., Hiatt, S. O., Bidwell, J. T., Denfeld, Q. E., ... Mudd, J. O. (2018). Implant Strategy-Specific Changes in Symptoms in Response to Left Ventricular Assist Devices. Journal of Cardiovascular Nursing, 33(2), 144-151. https://doi.org/10.1097/JCN.0000000000000430
Lee, Christopher S. ; Gelow, Jill M. ; Chien, Christopher V. ; Hiatt, Shirin O. ; Bidwell, Julie T. ; Denfeld, Quin E. ; Grady, Kathleen L ; Mudd, James O. / Implant Strategy-Specific Changes in Symptoms in Response to Left Ventricular Assist Devices. In: Journal of Cardiovascular Nursing. 2018 ; Vol. 33, No. 2. pp. 144-151.
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abstract = "Background: Although we know that the quality of life generally improves after left ventricular assist device (LVAD) implantation, we know little about how symptoms change in response to LVAD. Methods: The purpose of this study was to compare the changes in symptoms between bridge and destination therapy patients as part of a prospective cohort study. Physical (dyspnea and wake disturbances) and affective symptoms (depression and anxiety) were measured before LVAD and at 1, 3, and 6 months after LVAD. Multiphase growth modeling was used to capture the 2 major phases of change: Initial improvements between preimplant and 1 month after LVAD and subsequent improvements between 1 and 6 months after LVAD. Results: The sample included 64 bridge and 22 destination therapy patients as the preimplant strategy. Destination patients had worse preimplant dyspnea and wake disturbances, and they experienced greater initial improvements in these symptoms compared with bridge patients (all P <.05); subsequent change in both symptoms were similar between groups (both P >.05). Destination patients had worse preimplant depression (P =.042) but experienced similar initial and subsequent improvements in depression in response to LVAD compared with bridge patients (both P >.05). Destination patients had similar preimplant anxiety (P =.279) but experienced less initial and greater subsequent improvements in anxiety after LVAD compared with bridge patients (both P <.05). Conclusion: There are many differences in the magnitude and timing of change in symptom responses to LVAD between bridge and destination therapy patients. Detailed information on changes in specific symptoms may better inform shared decision-making regarding LVAD.",
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Implant Strategy-Specific Changes in Symptoms in Response to Left Ventricular Assist Devices. / Lee, Christopher S.; Gelow, Jill M.; Chien, Christopher V.; Hiatt, Shirin O.; Bidwell, Julie T.; Denfeld, Quin E.; Grady, Kathleen L; Mudd, James O.

In: Journal of Cardiovascular Nursing, Vol. 33, No. 2, 01.03.2018, p. 144-151.

Research output: Contribution to journalArticle

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T1 - Implant Strategy-Specific Changes in Symptoms in Response to Left Ventricular Assist Devices

AU - Lee, Christopher S.

AU - Gelow, Jill M.

AU - Chien, Christopher V.

AU - Hiatt, Shirin O.

AU - Bidwell, Julie T.

AU - Denfeld, Quin E.

AU - Grady, Kathleen L

AU - Mudd, James O.

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Background: Although we know that the quality of life generally improves after left ventricular assist device (LVAD) implantation, we know little about how symptoms change in response to LVAD. Methods: The purpose of this study was to compare the changes in symptoms between bridge and destination therapy patients as part of a prospective cohort study. Physical (dyspnea and wake disturbances) and affective symptoms (depression and anxiety) were measured before LVAD and at 1, 3, and 6 months after LVAD. Multiphase growth modeling was used to capture the 2 major phases of change: Initial improvements between preimplant and 1 month after LVAD and subsequent improvements between 1 and 6 months after LVAD. Results: The sample included 64 bridge and 22 destination therapy patients as the preimplant strategy. Destination patients had worse preimplant dyspnea and wake disturbances, and they experienced greater initial improvements in these symptoms compared with bridge patients (all P <.05); subsequent change in both symptoms were similar between groups (both P >.05). Destination patients had worse preimplant depression (P =.042) but experienced similar initial and subsequent improvements in depression in response to LVAD compared with bridge patients (both P >.05). Destination patients had similar preimplant anxiety (P =.279) but experienced less initial and greater subsequent improvements in anxiety after LVAD compared with bridge patients (both P <.05). Conclusion: There are many differences in the magnitude and timing of change in symptom responses to LVAD between bridge and destination therapy patients. Detailed information on changes in specific symptoms may better inform shared decision-making regarding LVAD.

AB - Background: Although we know that the quality of life generally improves after left ventricular assist device (LVAD) implantation, we know little about how symptoms change in response to LVAD. Methods: The purpose of this study was to compare the changes in symptoms between bridge and destination therapy patients as part of a prospective cohort study. Physical (dyspnea and wake disturbances) and affective symptoms (depression and anxiety) were measured before LVAD and at 1, 3, and 6 months after LVAD. Multiphase growth modeling was used to capture the 2 major phases of change: Initial improvements between preimplant and 1 month after LVAD and subsequent improvements between 1 and 6 months after LVAD. Results: The sample included 64 bridge and 22 destination therapy patients as the preimplant strategy. Destination patients had worse preimplant dyspnea and wake disturbances, and they experienced greater initial improvements in these symptoms compared with bridge patients (all P <.05); subsequent change in both symptoms were similar between groups (both P >.05). Destination patients had worse preimplant depression (P =.042) but experienced similar initial and subsequent improvements in depression in response to LVAD compared with bridge patients (both P >.05). Destination patients had similar preimplant anxiety (P =.279) but experienced less initial and greater subsequent improvements in anxiety after LVAD compared with bridge patients (both P <.05). Conclusion: There are many differences in the magnitude and timing of change in symptom responses to LVAD between bridge and destination therapy patients. Detailed information on changes in specific symptoms may better inform shared decision-making regarding LVAD.

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