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Rubinstein G, Lotan D, Moeller CM, DeFilippis EM, Slomovich S, Oren D, Yuzefpolskaya M, Sayer G, Uriel N. Sex differences in patients undergoing heart transplantation and LVAD therapy. Expert Rev Cardiovasc Ther 2022; 20:881-894. [PMID: 36409479 DOI: 10.1080/14779072.2022.2149493] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Left ventricular assist device (LVAD) and heart transplantation (HT) are the two life-sustaining therapies that have revolutionized the management of end-stage heart failure (HF). Yet, significant sex differences exist with respect to their use and effects. AREAS COVERED This review summarizes sex differences in the utilization, outcomes, and complications of LVAD and HT. Particular emphasis is placed on leading clinical trials in the field, historical and recent large registries-based analyses, as well as contemporary technological and policy changes affecting these differences. EXPERT OPINION Women with advanced HF remain under-treated with guideline-directed medical therapy and are less likely to be referred for consideration for LVAD and HT. This remains true despite newer LVAD technology and the new heart transplant allocation system. Community outreach, education, as well as increased representation of women in clinical research may reduce inequities.
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Affiliation(s)
- Gal Rubinstein
- Division of Cardiology, Center of Advance Cardiac Care, Columbia University Irving Medical Center/New York-Presbyterian Hospital New York, New York, NY, USA
| | - Dor Lotan
- Division of Cardiology, Center of Advance Cardiac Care, Columbia University Irving Medical Center/New York-Presbyterian Hospital New York, New York, NY, USA
| | - Cathrine M Moeller
- Division of Cardiology, Center of Advance Cardiac Care, Columbia University Irving Medical Center/New York-Presbyterian Hospital New York, New York, NY, USA
| | - Ersilia M DeFilippis
- Division of Cardiology, Center of Advance Cardiac Care, Columbia University Irving Medical Center/New York-Presbyterian Hospital New York, New York, NY, USA
| | - Sharon Slomovich
- Division of Cardiology, Center of Advance Cardiac Care, Columbia University Irving Medical Center/New York-Presbyterian Hospital New York, New York, NY, USA
| | - Daniel Oren
- Division of Cardiology, Center of Advance Cardiac Care, Columbia University Irving Medical Center/New York-Presbyterian Hospital New York, New York, NY, USA
| | - Melana Yuzefpolskaya
- Division of Cardiology, Center of Advance Cardiac Care, Columbia University Irving Medical Center/New York-Presbyterian Hospital New York, New York, NY, USA
| | - Gabriel Sayer
- Division of Cardiology, Center of Advance Cardiac Care, Columbia University Irving Medical Center/New York-Presbyterian Hospital New York, New York, NY, USA
| | - Nir Uriel
- Division of Cardiology, Center of Advance Cardiac Care, Columbia University Irving Medical Center/New York-Presbyterian Hospital New York, New York, NY, USA
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2
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Mahmoudi R, Moitie T, Dorent R, Guillemin F, Couchoud C. Implementation of patient‐reported outcome measures in a heart transplant recipient registry: first step toward a patient‐centered approach. Clin Transplant 2022; 36:e14708. [DOI: 10.1111/ctr.14708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/26/2022] [Accepted: 05/03/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Redouane Mahmoudi
- Direction médicale et scientifique Agence de la biomédecine Saint Denis La Plaine France
| | - Tiphaine Moitie
- Direction médicale et scientifique Agence de la biomédecine Saint Denis La Plaine France
| | - Richard Dorent
- Direction médicale et scientifique Agence de la biomédecine Saint Denis La Plaine France
- Département de cardiologie Hôpital Bichat – Claude‐Bernard Assistance Publique Hôpitaux de Paris Paris France
| | | | - Cécile Couchoud
- Direction médicale et scientifique Agence de la biomédecine Saint Denis La Plaine France
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3
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Postigo A, Martínez-Sellés M. Sex Influence on Heart Failure Prognosis. Front Cardiovasc Med 2020; 7:616273. [PMID: 33409293 PMCID: PMC7779486 DOI: 10.3389/fcvm.2020.616273] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 11/30/2020] [Indexed: 01/06/2023] Open
Abstract
Heart failure (HF) affects 1-2% of the population in developed countries and ~50% of patients living with it are women. Compared to men, women are more likely to be older and suffer hypertension, valvular heart disease, and non-ischemic cardiomyopathy. Since the number of women included in prospective HF studies has been low, much information regarding HF in women has been inferred from clinical trials observations in men and data obtained from registries. Several relevant sex-related differences in HF patients have been described, including biological mechanisms, age, etiology, precipitating factors, comorbidities, left ventricular ejection fraction, treatment effects, and prognosis. Women have greater clinical severity of HF, with more symptoms and worse functional class. However, females with HF have better prognosis compared to males. This survival advantage is particularly impressive given that women are less likely to receive guideline-proven therapies for HF than men. The reasons for this better prognosis are unknown but prior pregnancies may play a role. In this review article we aim to describe sex-related differences in HF and how these differences might explain why women with HF can expect to survive longer than men.
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Affiliation(s)
- Andrea Postigo
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,CIBER-CV, Madrid, Spain.,Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | - Manuel Martínez-Sellés
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,CIBER-CV, Madrid, Spain.,Facultad de Medicina, Universidad Complutense, Madrid, Spain.,Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea, Madrid, Spain
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4
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Almgren M, Lundqvist P, Lennerling A, Forsberg A. Self-efficacy, recovery and psychological wellbeing one to five years after heart transplantation: a Swedish cross-sectional study. Eur J Cardiovasc Nurs 2020; 20:34-39. [PMID: 33570591 DOI: 10.1177/1474515120927121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 04/27/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Self-efficacy refers to a person´s confidence in carrying out treatment-related activities and constitutes the foundation of self-management as well as long-term follow-up after heart transplantation. Exploring the heart recipients´ experiences by means of self-report instruments provides healthcare professionals with valuable information on how to supply self-management support after heart transplantation. AIMS The aim was to explore self-efficacy in relation to the self-reported level of recovery and psychological wellbeing, among adult heart recipients, one to 5 years after transplantation. METHODS This cross-sectional study includes 79 heart recipients, due for follow-up one to 5 years after transplantation. Three different self-assessment instruments were employed: the self-efficacy for managing chronic disease 6-item scale; the postoperative recovery profile; and the psychological general wellbeing instrument. RESULTS The reported level of self-efficacy was high (median 8.3, maximum score 10). Significantly higher self-efficacy was seen among those who had returned to work (P = 0.003) and those without pre-transplant mechanical circulatory support (P = 0.033). In total, 65.5% (n = 52) reported being reasonably recovered, while 18.8% (n = 12) were not recovered. The median total psychological general wellbeing score was 108 (P25 = 24, P75 = 117), suggesting overall good psychological wellbeing in the whole group of heart recipients. CONCLUSION The heart transplant recipients in our study had an overall high level of self-efficacy. Low self-efficacy was found among those with a low self-reported level of recovery, pre-transplant treatment with mechanical circulatory support or who had not returned to work. This is important information for transplant professionals when helping heart recipients to balance their expectations about recovery.
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Affiliation(s)
| | - Pia Lundqvist
- Institute of Health Sciences, Lund University, Sweden
| | - Annette Lennerling
- The Transplant Centre, Sahlgrenska University Hospital, Sweden.,Institute of Health and Care Sciences, University of Gothenburg, Sweden
| | - Anna Forsberg
- Institute of Health Sciences, Lund University, Sweden.,Department of Thoracic Surgery, Skåne University Hospital, Sweden
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6
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Doering LV, Chen B, Deng M, Mancini D, Kobashigawa J, Hickey K. Perceived control and health-related quality of life in heart transplant recipients. Eur J Cardiovasc Nurs 2018; 17:513-520. [PMID: 29260888 PMCID: PMC5984108 DOI: 10.1177/1474515117749225] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Perceived control has been associated with improved mental health and health-related quality of life (HRQOL) in cardiac populations. However, this concept has not been well-studied in heart transplant groups. AIMS We examine the relationship of perceived control to symptoms of anxiety and depression and HRQOL after transplant. We also examine the extent to which anxiety and depressive symptoms mediate the relationship between perceived control and HRQOL. METHODS Our cross-sectional analysis included 113 adult heart transplant patients from the NEW HEART study. High versus low perceived control groups were determined by median split for chi-square and t-test analyses. Hierarchical multiple linear regression models were used to examine the influence of perceived control on symptoms of depression and anxiety and HRQOL. Mediation analyses included Baron and Kenny's four-step regression approach and Preacher and Hayes' bootstrapping technique to test the indirect effect of perceived control on HRQOL. RESULTS Heart transplant patients who reported lower perceived control were more likely to be female ( p=0.003), and had significantly more depressive symptoms ( p<0.001) and anxiety ( p<0.001), and lower HRQOL ( p<0.001) than those with higher perceived control. Perceived control was a significant predictor in regression models of depressive and anxiety symptoms and HRQOL. In mediation analyses, depressive and anxiety symptoms mediated the effect of perceived control on HRQOL. CONCLUSION Perceived control is associated with improved depressive and anxiety symptoms and HRQOL after transplant. The relationship between perceived control and HRQOL is mediated by depressive and anxiety symptoms. Future interventions should target perceived control to improve overall HRQOL.
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Affiliation(s)
- Lynn V Doering
- Los Angeles School of Nursing, University of California, USA
| | - Belinda Chen
- Los Angeles School of Nursing, University of California, USA
| | - Mario Deng
- David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, Los Angeles, USA
| | - Donna Mancini
- Department of Medicine, Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, USA
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7
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McCartney SL, Patel C, Del Rio JM. Long-term outcomes and management of the heart transplant recipient. Best Pract Res Clin Anaesthesiol 2017; 31:237-248. [PMID: 29110796 DOI: 10.1016/j.bpa.2017.06.003] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/01/2017] [Accepted: 06/16/2017] [Indexed: 01/02/2023]
Abstract
Cardiac transplantation remains the gold standard in the treatment of advanced heart failure. With advances in immunosuppression, long-term outcomes continue to improve despite older and higher risk recipients. The median survival of the adult after heart transplantation is currently 10.7 years. While early graft failure and multiorgan system dysfunction are the most important causes of early mortality, malignancy, rejection, infection, and cardiac allograft vasculopathy contribute to late mortality. Chronic renal dysfunction is common after heart transplantation and occurs in up to 68% of patients by year 10, with 6.2% of patients requiring dialysis and 3.7% undergoing renal transplant. Functional outcomes after heart transplantation remain an area for improvement, with only 26% of patients working at 1-year post-transplantation, and are likely related to the high incidence of depression after cardiac transplantation. Areas of future research include understanding and managing primary graft dysfunction and reducing immunosuppression-related complications.
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Affiliation(s)
- Sharon L McCartney
- Divisions of Cardiothoracic and Critical Care Anesthesiology, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA.
| | - Chetan Patel
- Division of Cardiology, Department of Internal Medicine, Duke University Medical Center, Durham, NC, USA.
| | - J Mauricio Del Rio
- Divisions of Cardiothoracic and Critical Care Anesthesiology, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA.
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8
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Jalowiec A, Grady KL, White-Williams C. Mortality, rehospitalization, and post-transplant complications in gender-mismatched heart transplant recipients. Heart Lung 2017; 46:265-272. [PMID: 28501318 DOI: 10.1016/j.hrtlng.2017.04.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 04/11/2017] [Accepted: 04/11/2017] [Indexed: 12/26/2022]
Abstract
BACKGROUND Limited research has been published on outcomes in heart transplant (HT) recipients with gender-mismatched donors. OBJECTIVE Compare 3-year post-transplant outcomes in 2 groups of gender-mismatched HT recipients and a no-mismatch group. METHODS Sample: 347 HT recipients: 21.3% (74) received a heart from the opposite gender: Group 1: same gender donor/recipient (273, 78.7%); Group 2: female donor/male recipient (40, 11.5%); Group 3: male donor/female recipient (34, 9.8%). OUTCOMES mortality, hospitalization, and complications. RESULTS Female patients with male heart donors had shorter 3-year survival, were rehospitalized more days after HT discharge, and had more treated acute rejection episodes and cardiac allograft vasculopathy. No differences were found in: HT length of stay, respiratory failure, stroke, cancer, renal dysfunction, steroid-induced diabetes, number of IV-treated infections, or the timing of infection and rejection. CONCLUSION Female HT recipients with male donors had worse 3-year outcomes as compared to male-mismatch and no-mismatch groups.
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Affiliation(s)
- Anne Jalowiec
- School of Nursing, Loyola University, Chicago, IL, USA.
| | - Kathleen L Grady
- Center for Heart Failure, Bluhm Cardiovascular Institute, Division of Cardiac Surgery, Northwestern Memorial Hospital, Chicago, IL, USA; Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Connie White-Williams
- Center for Nursing Excellence, University of Alabama at Birmingham Hospital, Birmingham, AL, USA; University of Alabama at Birmingham School of Nursing, Birmingham, AL, USA
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9
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Hwang Y, Yi M. The Lived Experience of Patients with Heart Transplantation: A Phenomenological Study. J Korean Acad Nurs 2017; 47:110-120. [DOI: 10.4040/jkan.2017.47.1.110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 12/13/2016] [Accepted: 12/15/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Younghui Hwang
- Nursing Department, Yeoju Institute of Technology, Yeoju, Korea
| | - Myungsun Yi
- College of Nursing, Seoul National University, Seoul, Korea
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10
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Jalowiec A, Grady KL, White-Williams C. Clinical outcomes in overweight heart transplant recipients. Heart Lung 2016; 45:298-304. [PMID: 27086571 PMCID: PMC4935635 DOI: 10.1016/j.hrtlng.2016.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 02/28/2016] [Accepted: 03/03/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND Few studies have examined the impact of patient weight on heart transplant (HT) outcomes. OBJECTIVES Nine outcomes were compared in 2 groups of HT recipients (N = 347) based on their mean body mass index (BMI) during the first 3 years post-HT. METHODS Group 1 consisted of 108 non-overweight patients (BMI <25; mean age 52; 29.6% females; 16.7% minorities). Group 2 consisted of 239 overweight patients (BMI ≥25; mean age 52; 15.9% females; 13.8% minorities). Outcomes were: survival, re-hospitalization, rejections, infections, cardiac allograft vasculopathy (CAV), stroke, renal dysfunction, diabetes, and lymphoma. RESULTS Non-overweight patients had shorter survival, were re-hospitalized more days after the HT discharge, and had more lymphoma and severe renal dysfunction. Overweight patients had more CAV, steroid-induced diabetes, and acute rejections. CONCLUSIONS Overweight HT patients had better survival, but more rejections, CAV, and diabetes. Non-overweight HT patients had worse survival, plus more re-hospitalization time, lymphoma, and renal dysfunction.
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Affiliation(s)
- Anne Jalowiec
- School of Nursing, Loyola University of Chicago, Chicago, IL, USA.
| | - Kathleen L Grady
- Center for Heart Failure, Bluhm Cardiovascular Institute, Division of Cardiac Surgery, Northwestern Memorial Hospital, Chicago, IL, USA; Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Connie White-Williams
- Center for Nursing Excellence, University of Alabama at Birmingham Hospital, Birmingham, AL, USA; University of Alabama at Birmingham School of Nursing, Birmingham, AL, USA
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11
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Grady KL, Sherri Wissman, Naftel DC, Myers S, Gelijins A, Moskowitz A, Pagani FD, Young JB, Spertus JA, Kirklin JK. Age and gender differences and factors related to change in health-related quality of life from before to 6 months after left ventricular assist device implantation: Findings from Interagency Registry for Mechanically Assisted Circulatory Support. J Heart Lung Transplant 2016; 35:777-88. [PMID: 27068037 DOI: 10.1016/j.healun.2016.01.1222] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 12/11/2015] [Accepted: 01/28/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Gaps in the literature exist regarding health-related quality of life (HRQOL) early after left ventricular assist device (LVAD) surgery. The purposes of our study were to describe HRQOL over time, by age and gender, and identify risk factors for poor HRQOL early after LVAD implant. METHODS Patients (n = 7,353) from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database received a continuous-flow LVAD as a primary implant at 133 United States hospitals. Of these, 5,640 patients had pre-LVAD HRQOL data, 3,353 patients had 6-month post-LVAD HRQOL data, and 2,748 patients had data at both times. HRQOL was measured using the EQ-5D-3L (Euro-Qol) instrument. Data were collected pre-implant and 3 and 6 months post-operatively. Statistical analyses included chi-square test, t-test, Pearson correlation coefficients, and multiple regression analysis. RESULTS Overall HRQOL and dimensions of HRQOL improved from before to 6 months after device implant when examined by age and gender. However, younger patients and women reported significantly more problems regarding all dimensions before implant and significantly more problems regarding pain/discomfort and anxiety/depression at 3 and 6 months after implant. An increase in overall HRQOL from before to 6 months after implant was related to pre-implant INTERMACS Level 1. Factors related to a decrease in HRQOL from before to 6 months after implant were listed for heart transplant before surgery, comorbidities, better preoperative HRQOL, adverse events within 6 months after implant, bridge to transplant moderately likely and unlikely, and New York Heart Association Functional Classification IV at 6 months after LVAD (R(2) = 41%). CONCLUSIONS Overall HRQOL and dimensions of HRQOL improve in sub-groups of patients from before to 6 months after surgery, although differences in improvement exist. Adverse events are risk factors for decreased HRQOL across time and support the ongoing need to improve device technology with the aim of reducing adverse events.
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Affiliation(s)
- Kathleen L Grady
- Division of Cardiac Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
| | - Sherri Wissman
- Comprehensive Transplant Center, Ohio State University Medical Center, Columbus, Ohio
| | - David C Naftel
- Department of Surgery, University of Alabama, Birmingham, Birmingham, Alabama
| | - Susan Myers
- Department of Surgery, University of Alabama, Birmingham, Birmingham, Alabama
| | - Annetine Gelijins
- Department of Population Health Science and Policy, Mount Sinai Medical Center, New York, New York
| | - Alan Moskowitz
- Departments of Medicine and Population Health Science and Policy, Mount Sinai Medical Center, New York, New York
| | - Francis D Pagani
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - James B Young
- Department of Medicine, Cleveland Clinic Foundation Lerner College of Medicine, Cleveland, Ohio
| | - John A Spertus
- Division of Cardiovascular Research, St. Luke's Mid America Heart Institute, St. Luke's Mid America Heart Institute and University of Missouri Kansas City, Kansas City, Missouri
| | - James K Kirklin
- Department of Surgery, University of Alabama, Birmingham, Birmingham, Alabama
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12
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Grady KL, Andrei AC, Li Z, Rybarczyk B, White-Williams C, Gordon R, McGee EC. Gender differences in appraisal of stress and coping 5 years after heart transplantation. Heart Lung 2016; 45:41-7. [PMID: 26514074 PMCID: PMC4691446 DOI: 10.1016/j.hrtlng.2015.09.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 09/25/2015] [Accepted: 09/28/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVES We examined whether gender differences exist regarding stress, symptom distress, coping, adherence, and social support 5 years after heart transplantation. BACKGROUND Differences exist in health-related quality of life outcomes by gender after heart transplantation; women report poorer outcomes. METHODS Patients (n = 210, female = 42), were from a prospective, multi-site, study of health-related quality of life long-term after heart transplantation. Patients completed self-report instruments 5 years after heart transplantation (mean = 4.98 ± 0.17 years after transplant). Statistical analyses included two-sample t-tests, Chi-square or Fisher's exact test, and multivariable modeling. RESULTS Women did not report more overall stress or symptom distress, but reported more difficulty adhering to the transplant regimen, yet more actual adherence than men. Women reported using more negative coping styles, but reported more satisfaction with social support. CONCLUSIONS Gender differences exist regarding appraisal of stress, coping styles, and coping resources long-term after heart transplantation. These differences may guide tailoring therapy regarding stress, poor coping, and lack of resources.
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Affiliation(s)
- Kathleen L Grady
- Department of Surgery, Division of Cardiac Surgery, Northwestern University, Chicago, IL, USA.
| | - Adin-Cristian Andrei
- Department of Surgery, Division of Cardiac Surgery, Northwestern University, Chicago, IL, USA
| | - Zhi Li
- Department of Surgery, Division of Cardiac Surgery, Northwestern University, Chicago, IL, USA
| | - Bruce Rybarczyk
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Robert Gordon
- Department of Medicine, Division of Cardiology, Northwestern University, Chicago, IL, USA
| | - Edwin C McGee
- Department of Surgery, Division of Cardiac Surgery, Northwestern University, Chicago, IL, USA
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13
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Cook JL, Grady KL, Colvin M, Joseph SM, Brisco MA, Walsh MN. Sex differences in the care of patients with advanced heart failure. CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES 2015; 8:S56-9. [PMID: 25714825 DOI: 10.1161/circoutcomes.115.001730] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jennifer L Cook
- From the Cardiovascular Division, Medical University of South Carolina, Charleston (J.L.C., M.A.B.); Division of Cardiac Surgery, Northwestern University, Chicago, IL (K.L.G.); Cardiovascular Division, University of Michigan, Ann Arbor (M.C.); Cardiovascular Division, Washington University, St. Louis, MO (S.M.J.); and St. Vincent's Heart Center of Indiana, Indianapolis (M.N.W.).
| | - Kathleen L Grady
- From the Cardiovascular Division, Medical University of South Carolina, Charleston (J.L.C., M.A.B.); Division of Cardiac Surgery, Northwestern University, Chicago, IL (K.L.G.); Cardiovascular Division, University of Michigan, Ann Arbor (M.C.); Cardiovascular Division, Washington University, St. Louis, MO (S.M.J.); and St. Vincent's Heart Center of Indiana, Indianapolis (M.N.W.)
| | - Monica Colvin
- From the Cardiovascular Division, Medical University of South Carolina, Charleston (J.L.C., M.A.B.); Division of Cardiac Surgery, Northwestern University, Chicago, IL (K.L.G.); Cardiovascular Division, University of Michigan, Ann Arbor (M.C.); Cardiovascular Division, Washington University, St. Louis, MO (S.M.J.); and St. Vincent's Heart Center of Indiana, Indianapolis (M.N.W.)
| | - Susan M Joseph
- From the Cardiovascular Division, Medical University of South Carolina, Charleston (J.L.C., M.A.B.); Division of Cardiac Surgery, Northwestern University, Chicago, IL (K.L.G.); Cardiovascular Division, University of Michigan, Ann Arbor (M.C.); Cardiovascular Division, Washington University, St. Louis, MO (S.M.J.); and St. Vincent's Heart Center of Indiana, Indianapolis (M.N.W.)
| | - Meredith A Brisco
- From the Cardiovascular Division, Medical University of South Carolina, Charleston (J.L.C., M.A.B.); Division of Cardiac Surgery, Northwestern University, Chicago, IL (K.L.G.); Cardiovascular Division, University of Michigan, Ann Arbor (M.C.); Cardiovascular Division, Washington University, St. Louis, MO (S.M.J.); and St. Vincent's Heart Center of Indiana, Indianapolis (M.N.W.)
| | - Mary Norine Walsh
- From the Cardiovascular Division, Medical University of South Carolina, Charleston (J.L.C., M.A.B.); Division of Cardiac Surgery, Northwestern University, Chicago, IL (K.L.G.); Cardiovascular Division, University of Michigan, Ann Arbor (M.C.); Cardiovascular Division, Washington University, St. Louis, MO (S.M.J.); and St. Vincent's Heart Center of Indiana, Indianapolis (M.N.W.)
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Conway A, Schadewaldt V, Clark R, Ski C, Thompson DR, Doering L. The psychological experiences of adult heart transplant recipients: a systematic review and meta-summary of qualitative findings. Heart Lung 2013; 42:449-55. [PMID: 24035493 DOI: 10.1016/j.hrtlng.2013.08.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 08/01/2013] [Accepted: 08/02/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Psychosocial factors and physical health are associated with increased psychological distress post-heart transplant. Integrating findings from qualitative studies could highlight mechanisms for how these factors contribute to psychological well-being, thus aiding the development of interventions. OBJECTIVE To integrate qualitative findings regarding adult heart transplant recipients experiences, such as their emotions, perceptions and attitudes. METHODS A systematic review and meta-summary were conducted. Data from seven studies were categorized into 16 abstracted findings. RESULTS The most prominent finding across the studies related to recipients' perceptions of the importance of social support. Other prominent findings related to factors that promoted psychological well-being, such as faith, optimism and sense of control. CONCLUSIONS Psychological well-being may be improved by enhancing perceived control over health and daily life, promoting an optimistic outlook by facilitating access to social support from other heart transplant recipients and ensuring post-transplant recipient-caregiver partnerships adequately support the transition back to independence.
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Affiliation(s)
- Aaron Conway
- School of Nursing and Institute of Health and Biomedical Innovation, Queensland University of Technology, Level 7, 60 Musk Ave., Kelvin Grove, Queensland 4059, Australia.
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