Abstract
Background Left ventricular assist devices (LVADs) improve survival, quality of life (QOL), and functional capacity (FC) among patients with end-stage heart failure. Few data are available regarding characteristics associated with QOL and FC response. Methods and Results Patients enrolled in the Heartmate II clinical trials that were alive with ongoing LVAD support at 6 months were included. QOL response criteria included scoring above the lowest quartile on either the Minnesota Living With Heart Failure Questionnaire or the Kansas City Cardiomyopathy Questionnaire. FC responder criteria included improvement in 6-minute walk distance (6MWD) >70 meters from baseline, a 6MWD >220 meters at 6 months, or New York Heart Association functional class I or II. Independent variables associated with QOL nonresponse included history of diabetes (odds ratio [OR] 1.82, 95% confidence interval [CI] 1.20–2.78), lower mean pulmonary arterial pressure (OR 0.97, 95% CI 0.95–0.99), or a Heartmate II right ventricular risk score >2 (OR 1.77, 95% CI 1.00–3.12). Variables associated with FC nonresponse included history of COPD (OR 1.92, 95% CI 1.22–3.03) or diabetes (OR 1.52, 95% CI 1.01–2.27). Compared with responders, QOL and FC nonresponders had reduced long-term survival. Conclusions Preoperative comorbidities, including diabetes, COPD, and right heart failure, may limit the QOL and FC response to LVAD therapy and should be considered during the shared decision-making process.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 797-805 |
| Number of pages | 9 |
| Journal | Journal of Cardiac Failure |
| Volume | 22 |
| Issue number | 10 |
| DOIs | |
| State | Published - Oct 1 2016 |
Fingerprint
Keywords
- Left ventricular assist device
- exercise tolerance
- functional capacity
- heart failure
- predictors
- quality of life
- survival
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
}
Preoperative Determinants of Quality of Life and Functional Capacity Response to Left Ventricular Assist Device Therapy. / Kiernan, Michael S.; Sundareswaran, Kartik S.; Pham, Duc Thinh; Kapur, Navin K.; Pereira, Naveen L.; Strueber, Martin; Farrar, David J.; DeNofrio, David; Rogers, Joseph G.
In: Journal of Cardiac Failure, Vol. 22, No. 10, 01.10.2016, p. 797-805.Research output: Contribution to journal › Article
TY - JOUR
T1 - Preoperative Determinants of Quality of Life and Functional Capacity Response to Left Ventricular Assist Device Therapy
AU - Kiernan, Michael S.
AU - Sundareswaran, Kartik S.
AU - Pham, Duc Thinh
AU - Kapur, Navin K.
AU - Pereira, Naveen L.
AU - Strueber, Martin
AU - Farrar, David J.
AU - DeNofrio, David
AU - Rogers, Joseph G.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Background Left ventricular assist devices (LVADs) improve survival, quality of life (QOL), and functional capacity (FC) among patients with end-stage heart failure. Few data are available regarding characteristics associated with QOL and FC response. Methods and Results Patients enrolled in the Heartmate II clinical trials that were alive with ongoing LVAD support at 6 months were included. QOL response criteria included scoring above the lowest quartile on either the Minnesota Living With Heart Failure Questionnaire or the Kansas City Cardiomyopathy Questionnaire. FC responder criteria included improvement in 6-minute walk distance (6MWD) >70 meters from baseline, a 6MWD >220 meters at 6 months, or New York Heart Association functional class I or II. Independent variables associated with QOL nonresponse included history of diabetes (odds ratio [OR] 1.82, 95% confidence interval [CI] 1.20–2.78), lower mean pulmonary arterial pressure (OR 0.97, 95% CI 0.95–0.99), or a Heartmate II right ventricular risk score >2 (OR 1.77, 95% CI 1.00–3.12). Variables associated with FC nonresponse included history of COPD (OR 1.92, 95% CI 1.22–3.03) or diabetes (OR 1.52, 95% CI 1.01–2.27). Compared with responders, QOL and FC nonresponders had reduced long-term survival. Conclusions Preoperative comorbidities, including diabetes, COPD, and right heart failure, may limit the QOL and FC response to LVAD therapy and should be considered during the shared decision-making process.
AB - Background Left ventricular assist devices (LVADs) improve survival, quality of life (QOL), and functional capacity (FC) among patients with end-stage heart failure. Few data are available regarding characteristics associated with QOL and FC response. Methods and Results Patients enrolled in the Heartmate II clinical trials that were alive with ongoing LVAD support at 6 months were included. QOL response criteria included scoring above the lowest quartile on either the Minnesota Living With Heart Failure Questionnaire or the Kansas City Cardiomyopathy Questionnaire. FC responder criteria included improvement in 6-minute walk distance (6MWD) >70 meters from baseline, a 6MWD >220 meters at 6 months, or New York Heart Association functional class I or II. Independent variables associated with QOL nonresponse included history of diabetes (odds ratio [OR] 1.82, 95% confidence interval [CI] 1.20–2.78), lower mean pulmonary arterial pressure (OR 0.97, 95% CI 0.95–0.99), or a Heartmate II right ventricular risk score >2 (OR 1.77, 95% CI 1.00–3.12). Variables associated with FC nonresponse included history of COPD (OR 1.92, 95% CI 1.22–3.03) or diabetes (OR 1.52, 95% CI 1.01–2.27). Compared with responders, QOL and FC nonresponders had reduced long-term survival. Conclusions Preoperative comorbidities, including diabetes, COPD, and right heart failure, may limit the QOL and FC response to LVAD therapy and should be considered during the shared decision-making process.
KW - Left ventricular assist device
KW - exercise tolerance
KW - functional capacity
KW - heart failure
KW - predictors
KW - quality of life
KW - survival
UR - http://www.scopus.com/inward/record.url?scp=84957630690&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84957630690&partnerID=8YFLogxK
U2 - 10.1016/j.cardfail.2016.01.006
DO - 10.1016/j.cardfail.2016.01.006
M3 - Article
C2 - 26777757
AN - SCOPUS:84957630690
VL - 22
SP - 797
EP - 805
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
SN - 1071-9164
IS - 10
ER -