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Kawasaki S, Sakai Y, Harasawa S, Inatsu A, Kubota Y, Hirama A, Kashiwagi T, Iwabu M. The efficacy and safety of ivabradine hydrochloride in hemodialysis patients with chronic heart failure. Ther Apher Dial 2024; 28:354-363. [PMID: 38199237 DOI: 10.1111/1744-9987.14107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/20/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024]
Abstract
INTRODUCTION There is little evidence for ivabradine hydrochloride in patients undergoing hemodialysis. METHODS In this open-label prospective interventional trial of hemodialysis patients with chronic heart failure, during 12 weeks of treatment, changes in Heart rate (HR), frequency of dialysis-related hypotension were examined, and we investigated health-related quality of life (HR-QOL) and adverse effects. RESULTS 18 patients from 6 facilities were enrolled in the study. HR significantly decreased over time, from 87 ± 12.61/min at baseline to 75.85 ± 8.91/min (p = 0.0003), and systolic blood pressure also increased significantly (p < 0.0001). The frequency of dialysis-related hypotension was markedly reduced (p = 0.0001). The HR-QOL survey showed significant improvements in Social Functioning among others (p = 0.0178). No specific adverse events occurred. CONCLUSION Ivabradine hydrochloride improved dialysis-related hypotension. Furthermore, the HR-QOL improvement effect were suggested. These results demonstrated the safety and effectiveness of ivabradine hydrochloride.
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Affiliation(s)
- Sayuri Kawasaki
- Department of Endocrinology, Metabolism and Nephrology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
- Akihabara Kidney Clinic, Tokyo, Japan
- Ayase-ekimae Kidney Clinic, Tokyo, Japan
| | - Yukinao Sakai
- Department of Endocrinology, Metabolism and Nephrology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | | | | | - Yoshiaki Kubota
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Akio Hirama
- Department of Endocrinology, Metabolism and Nephrology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
- Kidney Clinic of Nippon Medical School, Tokyo, Japan
| | - Tetsuya Kashiwagi
- Department of Endocrinology, Metabolism and Nephrology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Masato Iwabu
- Department of Endocrinology, Metabolism and Nephrology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
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Asase M, Watanabe T, Takegami M, Nishimura K, Nin K, Fukushima N. Impact of Different Therapeutic Strategies With Left Ventricular Assist Devices on Health-Related Quality of Life During Prolonged Device-Based Support. Circ Rep 2023; 5:289-297. [PMID: 37431516 PMCID: PMC10329900 DOI: 10.1253/circrep.cr-22-0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/19/2023] [Accepted: 04/16/2023] [Indexed: 07/12/2023] Open
Abstract
Background: Left ventricular assist device (LVAD) implantation improves survival and health-related quality of life (HRQoL) of patients with heart failure. However, the impact of LVADs or different LVAD-based therapeutic strategies on long-term HRQoL has not been investigated. We evaluated the long-term HRQoL of Japanese patients who were treated with different LVAD-based therapeutic strategies. Methods and Results: Patients whose data were recorded in the Japanese Registry for Mechanical Assisted Circulatory Support between January 2010 and December 2018 were divided into 3 groups: primary implantable LVAD (G-iLVAD; n=483), primary paracorporeal LVAD (n=33), and bridge-to-bridge from paracorporeal to implantable LVAD (n=65). HRQoL was evaluated using the EuroQoL 5-dimension 3-level (EQ-5D-3L) before and 3 and 12 months after LVAD implantation; the mean EQ-5D-3L visual analog scale (VAS) score in the G-iLVAD group at these time points was 47.4, 71.1, and 72.9, respectively (where scores of 0 and 100 indicate worst and best imaginable health state, respectively). Changes in the least squares means of the VAS scores at 3 and 12 months after implantation differed significantly among the 3 groups. Social function, disability, and physical and mental problems were significantly lower in the G-iLVAD than other groups. Conclusions: HRQoL improved significantly at 3 and 12 months after LVAD implantation in all groups. Physical function showed a stronger improvement than did social function, disability, and mental function.
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Affiliation(s)
- Mariko Asase
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University Kyoto Japan
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center Suita Japan
| | - Takuya Watanabe
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center Suita Japan
| | - Misa Takegami
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Suita Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center Suita Japan
| | - Kazuko Nin
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University Kyoto Japan
| | - Norihide Fukushima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center Suita Japan
- Faculty of Nursing, Graduate School of Nursing, Senri Kinran University Suita Japan
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3
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Melendo-Viu M, Dobarro D, Raposeiras Roubin S, Llamas Pernas C, Moliz Cordón C, Vazquez Lamas M, Piñón Esteban M, Varela Martínez MÁ, Abu Assi E, Pita Romero R, Legarra Calderón JJ, Íñiguez Romo A. Left Ventricular Assist Device as a Destination Therapy: Current Situation and the Importance of Patient Selection. Life (Basel) 2023; 13:1065. [PMID: 37109593 PMCID: PMC10144236 DOI: 10.3390/life13041065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/16/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
Advanced heart failure is a growing problem for which the best treatment is cardiac transplantation. However, the shortage of donors' hearts made left ventricular assist devices as destination therapy (DT-LVAD) a highly recommended alternative: they improved mid-term prognosis as well as patients' quality of life. Current intracorporeal pumps with a centrifugal continuous flow evolved in the last few years. Since 2003, when first LVAD was approved for long-term support, smaller device sizes with better survival and hemocompatibility profile were reached. The most important difficulty lies in the moment of the implant. Recent indications range from INTERMACS class 2 to 4, with close monitoring in intermediate cases. Moreover, a large multiparametric study is needed for considering the candidacy: basal situation, with a special interest in frailty, comorbidities, including renal and hepatic dysfunction, and medical background, considering every prior cardiac condition, must be evaluated. In addition, some clinical risk scores can be helpful to measure the possibility of right heart failure or morbi-mortality. With this review, we sought to summarize all the device improvements, with their updated clinical results, as well as to focus on all the patient selection criteria.
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Affiliation(s)
- María Melendo-Viu
- Cardiology Department, University Hospital Álvaro Cunqueiro, 36213 Vigo, Spain
- Health Research Institute Galicia Sur, 36312 Vigo, Spain
- Faculty of Medicine, University Complutense of Madrid, 28040 Madrid, Spain
| | - David Dobarro
- Cardiology Department, University Hospital Álvaro Cunqueiro, 36213 Vigo, Spain
- Health Research Institute Galicia Sur, 36312 Vigo, Spain
| | - Sergio Raposeiras Roubin
- Cardiology Department, University Hospital Álvaro Cunqueiro, 36213 Vigo, Spain
- Health Research Institute Galicia Sur, 36312 Vigo, Spain
| | - Carmen Llamas Pernas
- Anaesthesiology Department, University Hospital Álvaro Cunqueiro, 36312 Vigo, Spain
| | - Candela Moliz Cordón
- Nephrology Department, Regional University Hospital of Málaga, 29010 Málaga, Spain
| | - Miriam Vazquez Lamas
- Anaesthesiology Department, University Hospital Álvaro Cunqueiro, 36312 Vigo, Spain
| | | | | | - Emad Abu Assi
- Cardiology Department, University Hospital Álvaro Cunqueiro, 36213 Vigo, Spain
- Health Research Institute Galicia Sur, 36312 Vigo, Spain
| | - Rafael Pita Romero
- Anaesthesiology Department, University Hospital Álvaro Cunqueiro, 36312 Vigo, Spain
| | | | - Andrés Íñiguez Romo
- Cardiology Department, University Hospital Álvaro Cunqueiro, 36213 Vigo, Spain
- Health Research Institute Galicia Sur, 36312 Vigo, Spain
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4
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Kato NP, Melnikov S, Denfeld QE, Casida J, Strömberg A, Ben-Gal T, Lee CS, Jaarsma T. Validity and reliability of the left ventricular assist device self-care behaviour scale. PLoS One 2023; 18:e0275465. [PMID: 36763631 PMCID: PMC9917258 DOI: 10.1371/journal.pone.0275465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/18/2022] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Adequate self-care behaviour is essential for patients with a left ventricular assist device (LVAD) to prevent complications, prolong life, and optimise quality of life. However, there were no valid and reliable measurements available to assess self-care behaviour among patients with LVAD. We have previously developed the 33-item LVAD self-care behaviour scale. OBJECTIVES To evaluate psychometric properties of the 33-item LVAD self-care behaviour scale. METHODS AND RESULTS Data on 127 patients with a LVAD in Israel, Japan, and the USA were analysed (mean age 51±14.3, 81% male). Exploratory factor analysis extracted three factors, and 13 items were excluded from the scale. Internal consistency assessed by Cronbach's alpha was acceptable for the total scale (α = 0.80) and the three subscales: Factor 1: Monitoring (α = 0.81), Factor 2: Heart failure self-care (α = 0.67), and Factor 3: LVAD self-care (α = 0.63). The 20-item version of the LVAD self-care behaviour scale had sufficient convergent validity with another scale that assessed self-care related to the driveline of LVAD (r = 0.47, p<0.001). Test-retest reliability was adequate (intraclass correlation coefficient = 0.58). CONCLUSIONS The 20-item version of the LVAD self-care behaviour scale showed adequate validity and reliability. The scale is ready for use in clinical practice and research. Additional testing might further optimise the scale.
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Affiliation(s)
- Naoko P. Kato
- Department of Health, Division of Nursing Sciences and Reproductive Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Therapeutic Strategy for Heart Failure, The University of Tokyo Hospital, Tokyo, Japan
- * E-mail:
| | - Semyon Melnikov
- Sackler Faculty of Medicine, Department of Nursing, Stanley Steyer School of Health Professions, Tel Aviv University, Tel Aviv, Israel
| | - Quin E. Denfeld
- School of Nursing & Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, United States of America
| | - Jesus Casida
- Eleanor Mann School of Nursing, The University of Arkansas, Fayetteville, Arkansas, United States of America
| | - Anna Strömberg
- Department of Health, Division of Nursing Sciences and Reproductive Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Tuvia Ben-Gal
- Sackler Faculty of Medicine, Heart Failure Unit, Cardiology Department, Rabin Medical Center, Petah Tikva, Tel Aviv University, Tel Aviv, Israel
| | - Christopher S. Lee
- The Boston College William F. Connell School of Nursing, Chestnut Hill, Massachusetts, United States of America
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Tiny Jaarsma
- Department of Health, Division of Nursing Sciences and Reproductive Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Willy K, Ellermann C, Reinke F, Rath B, Wolfes J, Eckardt L, Doldi F, Wegner FK, Köbe J, Morina N. The Impact of Cardiac Devices on Patients’ Quality of Life—A Systematic Review and Meta-Analysis. J Cardiovasc Dev Dis 2022; 9:jcdd9080257. [PMID: 36005421 PMCID: PMC9409697 DOI: 10.3390/jcdd9080257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/03/2022] [Accepted: 08/06/2022] [Indexed: 12/13/2022] Open
Abstract
The implantation of cardiac devices significantly reduces morbidity and mortality in patients with cardiac arrhythmias. Arrhythmias as well as therapy delivered by the device may impact quality of life of patients concerned considerably. Therefore we aimed at conducting a systematic search and meta-analysis of trials examining the impact of the implantation of cardiac devices, namely implantable cardioverter-defibrillators (ICD), pacemakers and left-ventricular assist devices (LVAD) on quality of life. After pre-registering the trial with the PROSPERO database, we searched Medline, PsycINFO, Web of Science and the Cochrane databases for relevant publications. Study quality was assessed by two independent reviewers using standardized protocols. A total of 37 trials met our inclusion criteria. Of these, 31 trials were cohort trials while 6 trials used a randomized controlled design. We found large pre-post effect sizes for positive associations between quality of life and all types of devices. The effect sizes for LVAD, pacemaker and ICD patients were g = 1.64, g = 1.32 and g = 0.64, respectively. There was a lack of trials examining the effect of implantation on quality of life relative to control conditions. Trials assessing quality of life in patients with cardiac devices are still scarce. Yet, the existing data suggest beneficial effects of cardiac devices on quality of life. We recommend that clinical trials on cardiac devices routinely assess quality of life or other parameters of psychological well-being as a decisive study endpoint. Furthermore, improvements in psychological well-being should influence decisions about implantations of cardiac devices and be part of patient education and may impact shared decision-making.
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Affiliation(s)
- Kevin Willy
- Department for Cardiology II: Electrophysiology, University Hospital Münster, 48149 Münster, Germany
- Department of Psychology, University of Münster, 48149 Münster, Germany
- Correspondence: ; Tel.: +49-251-83-44949; Fax: +49-251-83-52980
| | - Christian Ellermann
- Department for Cardiology II: Electrophysiology, University Hospital Münster, 48149 Münster, Germany
| | - Florian Reinke
- Department for Cardiology II: Electrophysiology, University Hospital Münster, 48149 Münster, Germany
| | - Benjamin Rath
- Department for Cardiology II: Electrophysiology, University Hospital Münster, 48149 Münster, Germany
| | - Julian Wolfes
- Department for Cardiology II: Electrophysiology, University Hospital Münster, 48149 Münster, Germany
| | - Lars Eckardt
- Department for Cardiology II: Electrophysiology, University Hospital Münster, 48149 Münster, Germany
| | - Florian Doldi
- Department for Cardiology II: Electrophysiology, University Hospital Münster, 48149 Münster, Germany
| | - Felix K. Wegner
- Department for Cardiology II: Electrophysiology, University Hospital Münster, 48149 Münster, Germany
| | - Julia Köbe
- Department for Cardiology II: Electrophysiology, University Hospital Münster, 48149 Münster, Germany
| | - Nexhmedin Morina
- Department of Psychology, University of Münster, 48149 Münster, Germany
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6
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Suzuki F, Sato H, Akiyama M, Akiba M, Adachi O, Harada T, Saiki Y, Kohzuki M. Changes in the Quality of Life of Patients with Left Ventricular Assist Device and Their Caregivers in Japan: Retrospective Observational Study. TOHOKU J EXP MED 2022; 257:45-55. [PMID: 35354693 DOI: 10.1620/tjem.2022.j016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Fumika Suzuki
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine
| | - Hiroe Sato
- Health Administration Centerr, Niigata University
| | - Masatoshi Akiyama
- Department of Cardiovascular Surgery, Saitama Medical University International Medical Center
| | - Miki Akiba
- Division of Organ Transplantation, Tohoku University Hospital
| | - Osamu Adachi
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine
| | - Taku Harada
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine
| | - Yoshikatsu Saiki
- Department of Cardiovascular Surgery, Tohoku University Graduate School of Medicine
| | - Masahiro Kohzuki
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine
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7
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Quality of Life Following Urgent LVAD Implantation for ECMO Therapy in Cardiogenic Shock: A Long-Term Follow-Up. MEDICINA-LITHUANIA 2021; 57:medicina57080747. [PMID: 34440953 PMCID: PMC8398622 DOI: 10.3390/medicina57080747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 07/18/2021] [Accepted: 07/21/2021] [Indexed: 01/30/2023]
Abstract
Background and Objectives: Over the past decade, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has developed into a mainstream treatment for refractory cardiogenic shock (CS) to maximal conservative management. Successful weaning of VA-ECMO may not be possible, and bridging with further mechanical circulatory support (MCS), such as urgent implantation of a left ventricular assist device (LVAD), may represent the only means to sustain the patient haemodynamically. In the recovery phase, many survivors are not suitably prepared physically or psychologically for the novel issues encountered during daily life with an LVAD. Materials and Methods: A retrospective analysis of our institutional database between 2012 and 2019 was performed to identify patients treated with VA-ECMO for CS who underwent urgent LVAD implantation whilst on MCS. Post-cardiotomy cases were excluded. QoL was assessed prospectively during a routine follow-up visit using the EuroQol-5 dimensions-5 level (EQ-5D-5L) and the Patient Health Questionnaire (PHQ-9) surveys. Results: Among 126 in-hospital survivors of VA-ECMO therapy due to cardiogenic shock without prior cardiac surgery, 31 (24.6%) urgent LVAD recipients were identified. In 11 (36.7%) cases, cardiopulmonary resuscitation (CPR) was performed (median 10, range 1–60 min) before initiation of VA-ECMO, and in 5 (16.7%) cases, MCS was established under CPR. Mean age at LVAD implantation was 51.7 (+/−14) years and surgery was performed after a mean 12.1 (+/−8) days of VA-ECMO support. During follow-up of 46.9 (+/−25.5) months, there were 10 deaths after 20.4 (+/−12.1) months of LVAD support. Analysis of QoL questionnaires returned a mean EQ-5D-5L score of 66% (+/−21) of societal valuation for Germany and a mean PHQ-9 score of 5.7 (+/−5) corresponding to mild depression severity. When compared with 49 elective LVAD recipients without prior VA-ECMO therapy, there was no significant difference in QoL results. Conclusions: Patients requiring urgent LVAD implantation under VA-ECMO support due to CS are associated with comparable quality of life without a significant difference from elective LVAD recipients. Close follow-up is required to oversee patient rehabilitation after successful initial treatment.
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Levelink M, Brütt AL. Factors influencing health-related quality of life of patients with a left ventricular assist device: a systematic review and thematic synthesis. Eur J Cardiovasc Nurs 2021; 20:803-815. [PMID: 34263313 DOI: 10.1093/eurjcn/zvab056] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/04/2021] [Accepted: 06/07/2021] [Indexed: 11/14/2022]
Abstract
AIMS Left ventricular assist devices (LVADs) are increasingly being used in the treatment of advanced heart failure. Left ventricular assist device patients frequently report improvements in health-related quality of life (HRQOL) post-implantation. However, HRQOL varies over time and between patients, which can be explained by patient-related and environmental factors, as individual studies suggest. This review aims to synthesize qualitative evidence on factors influencing HRQOL of LVAD patients. METHODS AND RESULTS We systematically searched the databases PubMed, Scopus, PsycINFO, and CINAHL for qualitative studies on factors influencing HRQOL of patients with continuous flow LVADs. The included papers were synthesized using a thematic synthesis. The results were validated in discussion with a patient and practical implications were jointly developed. We included 11 papers and developed 7 themes that represent influencing factors for HRQOL of LVAD patients: disease experiences, emotional reactivity, heart failure and mechanical circulatory support symptoms, medical care, self-care, self-concept, and social environment. CONCLUSION The identified themes highlight influencing factors on HRQOL. These help to explain variation in patient outcomes and to better consider the individual situation in rehabilitation. Based on the results, four strategies are proposed for promoting psychosocial outcomes: facilitate self-care, ensure social support, offer psychosocial support, and manage patient expectations.
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Affiliation(s)
- Michael Levelink
- Department of Health Services Research, Carl von Ossietzky Universität Oldenburg, School of Medicine and Health Sciences, Ammerländer Heerstr. 114-118, Oldenburg 26129, Germany
| | - Anna Levke Brütt
- Department of Health Services Research, Carl von Ossietzky Universität Oldenburg, School of Medicine and Health Sciences, Ammerländer Heerstr. 114-118, Oldenburg 26129, Germany
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9
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Itzhaki Ben Zadok O, Ben-Avraham B, Jaarsma T, Shaul A, Hammer Y, Barac YD, Mats I, Eldar O, Abuhazira M, Yaari V, Gulobov D, Mulu M, Aravot D, Kornowski R, Ben-Gal T. Health-related quality of life in left ventricular assist device-supported patients. ESC Heart Fail 2021; 8:2036-2044. [PMID: 33773095 PMCID: PMC8120365 DOI: 10.1002/ehf2.13282] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/01/2021] [Accepted: 02/12/2021] [Indexed: 12/28/2022] Open
Abstract
Aims This study aimed to evaluate the different health‐related quality of life (HR‐QoL) aspects in patients with both short‐term and long‐term duration LVAD support at pre‐specified time intervals. Methods and results We performed a single‐centre HR‐QoL analysis of short‐term and long‐term LVAD‐supported patients using the short version of the Kansas City Cardiomyopathy Questionnaire (KCCQ‐12) and the Changes in Sexual Functioning Questionnaire along with a survey to evaluate patients' social and driving routines. Data were collected at baseline and at 6 or 12 month follow‐up. Included were 46 patients with a median time from LVAD implantation of 1.1 [inter‐quartile range (IQR) 0.5, 2.6] years. The median KCCQ‐12 summary score was 56 (IQR 29, 74) with most favourable scores in the symptom frequency domain [75 (IQR 50, 92)] and worse scores in the physical limitation [42 (IQR 25, 75)] and QoL [44 (IQR 25, 75)] domains. No significant changes were apparent during study follow‐up [KCCQ‐12 summary score 56 (IQR 35, 80)], and no significant correlation between the KCCQ‐12 summary score and ventricular assist device‐support duration was detected (r = −0.036, P = 0.812). Sexual dysfunction was noted across all domains with a cumulative score of 31 (IQR 22, 42). Seventy‐six per cent of patients resumed driving after LVAD implantation, and 43% of patients reported they socialize with family and friends more frequently since surgery. Conclusions Short‐term and long‐term LVAD‐supported patients had impaired HR‐QoL and sexual function at baseline and at follow‐up yet reported an improvement in social interactions and independency. A broader spectrum of patient's reported HR‐QoL measures should be integrated into the pre‐LVAD implantation assessment and preparation.
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Affiliation(s)
- Osnat Itzhaki Ben Zadok
- Department of Cardiology, Rabin Medical Center, 39 Jabotinsky St, Petah Tikva, 49100, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Binyamin Ben-Avraham
- Department of Cardiology, Rabin Medical Center, 39 Jabotinsky St, Petah Tikva, 49100, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tiny Jaarsma
- Department of Nursing Science, Julius Center, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Medicine, Health and Care, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Aviv Shaul
- Department of Cardiology, Rabin Medical Center, 39 Jabotinsky St, Petah Tikva, 49100, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yoav Hammer
- Department of Cardiology, Rabin Medical Center, 39 Jabotinsky St, Petah Tikva, 49100, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yaron D Barac
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Cardio-Thoracic Surgery, Rabin Medical Center, Petah Tikva, Israel
| | - Israel Mats
- Department of Cardiology, Rabin Medical Center, 39 Jabotinsky St, Petah Tikva, 49100, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Orit Eldar
- Department of Cardiology, Rabin Medical Center, 39 Jabotinsky St, Petah Tikva, 49100, Israel
| | - Miriam Abuhazira
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Cardio-Thoracic Surgery, Rabin Medical Center, Petah Tikva, Israel
| | - Vicky Yaari
- Department of Cardiology, Rabin Medical Center, 39 Jabotinsky St, Petah Tikva, 49100, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dmitry Gulobov
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Cardio-Thoracic Surgery, Rabin Medical Center, Petah Tikva, Israel
| | - Mastwal Mulu
- Department of Cardiology, Rabin Medical Center, 39 Jabotinsky St, Petah Tikva, 49100, Israel
| | - Dan Aravot
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Cardio-Thoracic Surgery, Rabin Medical Center, Petah Tikva, Israel
| | - Ran Kornowski
- Department of Cardiology, Rabin Medical Center, 39 Jabotinsky St, Petah Tikva, 49100, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tuvia Ben-Gal
- Department of Cardiology, Rabin Medical Center, 39 Jabotinsky St, Petah Tikva, 49100, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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10
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Melnikov S, Abuhazira M, Golobov D, Yaari V, Jaarsma T, Ben Gal T. Factors associated with body image among patients with an implanted left ventricular assist device. Heart Lung 2020; 49:803-807. [PMID: 33010518 DOI: 10.1016/j.hrtlng.2020.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/19/2020] [Accepted: 08/24/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Among Left Ventricular Assist Device (LVAD) implanted patients, body image modifications might occur. OBJECTIVES To explore the associations between sexual functioning, confidence in LVAD technology, personal wellbeing, and body image. METHODS The cross-sectional study included 30 conveniently recruited LVAD implanted patients who completed Body Image Scale, sexual functioning, confidence in LVAD technology, and Personal Wellbeing Index questionnaires. The associations between the research variables were examined with multiple regression analyses. RESULTS The mean age of the participants was 63 (SD=10), 90% were men. The mean scores were: sexual functioning - 2.43 (SD=1.20, range 1-5); confidence in LVAD technology - 2.63 (SD=1.04, range 1-5); Well-Being Index - 6.61 (SD=1.53, range 0-10); and body image - 14.5 (SD=4.17, range 5-20). Sexual functioning (p<.01) and LVAD technology confidence (p=.04) significantly predicted body image. CONCLUSIONS Healthcare professionals should be aware of challenges regarding body image faced by LVAD implanted patients and to address related factors.
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Affiliation(s)
- Semyon Melnikov
- Department of Nursing, Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | | | | | | | - Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, University of Linköping, Linköping, Sweden.
| | - Tuvia Ben Gal
- Rabin Medical Center, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Okam NA, Ahmad W, Rana D, Torrilus C, Jahan N, Sedrakyan S. Psychological Spectrum Experienced by Heart Failure Patients After Left Ventricular Assist Device Implantation. Cureus 2020; 12:e9671. [PMID: 32923266 PMCID: PMC7485994 DOI: 10.7759/cureus.9671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 08/11/2020] [Indexed: 11/06/2022] Open
Abstract
Depression and anxiety disorders are prevalent in patients with heart failure. They are associated with adverse effects such as rapid disease progression, poor medication compliance, low quality of life and increased mortality rate. The current literature review aims to provide an overview of the overall rate of depression in patients who receive left ventricular assist device (LVAD) implantation and identify the psychological phases that these individuals experienced peri- and post-LVAD implantation. A PubMed search using regular and Medical Subject Headings (MeSH) keywords identified 239 articles. After applying inclusion/exclusion criteria, removal of duplicate studies, and careful review of articles, 40 studies provided relevant information on our primary end-point. These 40 studies selected include 13 paid articles with abstracts and 27 free full-text articles comprising eight prospective cohort studies, five retrospective cohort studies, six cross-sectional studies, one qualitative study, one randomized clinical trial, one systematic review, four literature reviews, and one practice guide. Our review shows that patients experienced different psychological phases after LVAD implantation. However, as the time from implantation progressed, these patients showed a significant improvement in depression, anxiety, and health-related quality of life.
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Affiliation(s)
- Nkechi A Okam
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Wiqas Ahmad
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Dibyata Rana
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Chenet Torrilus
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Nusrat Jahan
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Surik Sedrakyan
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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12
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White-Williams C, Fazeli PL, Kirklin JK, Pamboukian SV, Grady KL. Differences in health-related quality of life by implant strategy: Analyses from the Interagency Registry for Mechanically Assisted Circulatory Support. J Heart Lung Transplant 2020; 39:62-73. [DOI: 10.1016/j.healun.2019.10.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 10/28/2019] [Accepted: 10/28/2019] [Indexed: 11/24/2022] Open
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13
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Bakhai S, Bhardwaj A, Phan H, Varghese S, Gudleski GD, Reynolds JL. Optimisation of diagnosis and treatment of heart failure in a primary care setting. BMJ Open Qual 2019; 8:e000660. [PMID: 31673640 PMCID: PMC6797327 DOI: 10.1136/bmjoq-2019-000660] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 09/06/2019] [Accepted: 09/30/2019] [Indexed: 11/22/2022] Open
Abstract
Background Heart failure (HF) is one of the leading causes of emergency department visits and hospital admissions in the USA. We identified a gap in the diagnosis and the use of guideline-directed medical therapy in patients with HF at the internal medicine clinic. Aim To improve the diagnosis and treatment of HF, as well as to reduce emergency department visits and hospitalisation over 12 months in patients aged 40–75 years. Methods The multidisciplinary quality improvement (QI) team performed a root cause analysis and identified barriers to optimal guideline-directed medical therapy. Rates of patients on guideline-directed medical therapy with systolic HF diagnosis, emergency department visits and hospital admissions were the outcome measures. The process measures included echocardiogram order and completion rates, and rates of accurate classification of HF from the baseline rate of less than 10%. We used the focus, analyse, develop, execute and evaluate (FADE) model with five improvement cycles. The major components of interventions included (1) leveraging health information technology; (2) optimising teamwork; and (3) providing education to patients, physicians and internal medicine clinic staff. Data were analysed using statistical process control and run charts. Results We observed a reduction in the total number of emergency department visits (160 vs 108), hospital admissions (117 vs 114) and observation visits (22 vs 16) comparing the 1-year preproject and 1-year postproject periods. An increase in the use of ACE inhibitors or angiotensin receptor blockers occurred from the baseline rate of 20%–37% during the second half of the project and was sustained at 71.4% (median) during 6 months of the postproject period. Conclusions We achieved a sustainable increase in the accurate diagnosis of HF and achieved 80% diagnosis during the 6-month poststudy period.
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Affiliation(s)
- Smita Bakhai
- Medicine, Division of Internal Medicine, University at Buffalo-The State University of New York, Buffalo, New York, USA
| | - Aishwarya Bhardwaj
- Medicine, Division of Internal Medicine, University at Buffalo-The State University of New York, Buffalo, New York, USA
| | - Huy Phan
- Medicine, Division of Internal Medicine, University at Buffalo-The State University of New York, Buffalo, New York, USA
| | - Shane Varghese
- Medicine, Division of Internal Medicine, University at Buffalo-The State University of New York, Buffalo, New York, USA
| | - Gregory D Gudleski
- Medicine, Division of Behavioral Medicine, University at Buffalo-The State University of New York, Buffalo, New York, USA
| | - Jessica L Reynolds
- Medicine, Divison of Allergy, Immunology & Rheumatology, University at Buffalo-The State University of New York, Buffalo, New York, USA
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14
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Kato NP, Jaarsma T, Casida JM, Lee CS, Strömberg A, Gal TB. Development of an Instrument for Measuring Self-Care Behaviors After Left Ventricular Assist Device Implantation. Prog Transplant 2019; 29:335-343. [DOI: 10.1177/1526924819874358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:Successful long-term left ventricular assist device (LVAD) therapy necessitates a high degree of self-care. We aimed to develop an instrument that measures self-care behaviors in adult patients living with an LVAD.Methods:We used the method to develop patient-reported outcomes recommended by the US Food and Drug Administration. Prior to developing the instrument, a literature review was conducted to generate items using the middle-range theory of self-care of chronic illness as a guiding framework. A 2-round Delphi method, involving 17 clinicians with expertise in heart failure and assist devices from the Netherlands, Israel, United States, Canada, and Japan, was used to generate and select items. In the first Delphi survey, the levels of importance, relevance, and clarity of items in the instrument were evaluated. The second Delphi survey was performed to gain consensus on the final selection of items. We also examined face validity.Results:A preliminary 37-item version of the Self-Care Behavior Scale was produced. The first panel judged 33 items as important and relevant, taking out 4 items due to vague wording and duplication and adding in 4 items. In the final 33-item version, 19 items address self-care maintenance behaviors, 10 items address self-care monitoring behaviors, and 4 items address self-care management behaviors. Patients (N = 25) did not have any difficulties understanding items and report any missing items.Conclusion:The 33-item Self-Care Behavior Scale for patients with heart failure having an LVAD has been developed and is ready for further psychometric testing.
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Affiliation(s)
- Naoko P. Kato
- Division of Nursing Science, Department of Social and Welfare Studies, Linköping University, Sweden
- Department of Therapeutic Strategy for Heart Failure, The University of Tokyo Graduate School of Medicine, Japan
| | - Tiny Jaarsma
- Division of Nursing Science, Department of Social and Welfare Studies, Linköping University, Sweden
| | - Jesus M. Casida
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Christopher S. Lee
- Oregon Health and Science University School of Nursing and Knight Cardiovascular Institute, Portland, OR, USA
- Boston College, Willian F. Connell School of Nursing, Chestnut Hill, MA, USA
| | - Anna Strömberg
- Division of Nursing Science, Department of Cardiology and Department of Medical and Health Sciences, Linköping University, Sweden
| | - Tuvia Ben Gal
- Heart Failure Unit, Cardiology Department, Rabin Medical Center, Petah Tikva, Sackler School of Medicine, Tel Aviv University, Israel
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15
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Seo YG, Park WH, Oh S, Sung J, Jeon ES, Choi JO, Oh JK, Kim YH, Kim HY, Jang MJ, Choi NG, Cho YH. Clinical outcomes of inpatient cardiac rehabilitation for patients with treated left ventricular assist device in Korea: 1-year follow-up. J Exerc Rehabil 2019; 15:481-487. [PMID: 31316945 PMCID: PMC6614778 DOI: 10.12965/jer.1938124.062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 04/07/2019] [Indexed: 11/22/2022] Open
Abstract
In Korea, the first patient with a left ventricular assist device (LVAD) for destination therapy had successful implantation of a continuous-flow model in 2012. We investigated the safety and efficacy of exercise therapy with LVAD implantation 15 Korean patients. We retrospectively reviewed 15 patients (mean age, 67.4±11.6 years; 10 males, 5 female, left ventricular ejection fraction 23.6%±7.1%), including 4 with implanted continuous-flow and 11 an axial-flow LVAD. The New York Heart Association functional classification, ejection fraction, and quality of life were obtained. Survival rate, adverse events, admission rates, and enrollment rates in cardiac rehabilitation were investigated. Survival at 6 and 12 months was 100% and 89%, respectively. The New York Heart Association functional classification improved from 3.4±0.5 to 2.3±0.05 at 12 months postoperatively (P<0.0001). The ejection fraction significantly increased from 23.6%±7.2% on the preoperative day to 35.4%±14.2% at 1 year (P<0.0018). The quality of life was also improved at 1 year (P<0.0001). The most common adverse events were bleeding (56%) and dyspnea (44%). The number of admissions was 3.2 per patient-year. LVAD therapy is a safe and effective treatment option with exercise intervention for Korean patients waiting for heart transplantation or those who were ineligible for heart transplantation. A larger study with longer follow-up is needed to determine details clinical outcomes after LVAD.
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Affiliation(s)
- Yong Gon Seo
- Division of Sports Medicine, Department of Orthopedic Surgery, Samsung Medical Center, Seoul, Korea
| | - Won Hah Park
- Division of Sports Medicine, Department of Orthopedic Surgery, Samsung Medical Center, Seoul, Korea
| | - SuKi Oh
- Division of Sports Medicine, Department of Orthopedic Surgery, Samsung Medical Center, Seoul, Korea
| | - Jidong Sung
- Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Seoul, Korea
| | - Eun Seok Jeon
- Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Seoul, Korea
| | - Jin Oh Choi
- Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Seoul, Korea
| | - Jae K Oh
- Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Seoul, Korea
| | - Yun Hee Kim
- Cardiac Rehabilitation and Prevention Center, Samsung Medical Center, Seoul, Korea
| | - Ho Young Kim
- Cardiac Rehabilitation and Prevention Center, Samsung Medical Center, Seoul, Korea
| | - Mi Ja Jang
- Department of Nursing, Cardiac Rehabilitation and Prevention Center, Samsung Medical Center, Seoul, Korea
| | - Nam Gyung Choi
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Seoul, Korea
| | - Yang Hyun Cho
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Seoul, Korea
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16
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Zhang R, Huang J, Shu Q, Wu L, Zhang Q, Meng Y. Improvement in quality of life of Chinese chronic heart failure patients with neuropsychiatric complications over 12-months post-treatment with metoprolol. Medicine (Baltimore) 2019; 98:e14252. [PMID: 30681618 PMCID: PMC6358404 DOI: 10.1097/md.0000000000014252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Psychological disorders, such as depression and anxiety, are known to be associated with chronic heart failure (CHF). The present study was conducted to evaluate the effect of mental status on quality of life (QoL) in metoprolol treated CHF patients with depression, anxiety, and burn-out.This single-center prospective study was conducted between February 2013 and April 2016, enrolled CHF patients (resting heart rate >80 bpm) with depression, anxiety, and burn out at baseline. Hospital anxiety and depression scale (HADS) and Copenhagen burnout inventory (CBI) were used to assess the depression-anxiety status and burn-out status, respectively. Change in QoL was evaluated as the endpoint at 1st, 3rd, 6th, and 12th month from baseline using Minnesota Living with Heart Failure Questionnaire (MLHFQ) and short form-8 (SF-8) scales. A student t test was used to determine the change and P value < .05 was considered statistically significant. One hundred fifty-four patients were enrolled (median age 66 years; 65.58% males) and divided into 8 groups based on the HADS and CBI scores at baseline. Overall, the mean SF8 score and MLHFQ scores in different mental status groups showed a significant improvement (P < .05) in QoL from baseline to 12th month, with no significant difference reported between the groups. With regard to the follow-up periods, there was a deterioration in QoL until 3rd month, after which there was a significant improvement (P < .05).There was a significant improvement in QoL in metoprolol treated CHF patients with depression, anxiety, and burn-out.
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17
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Cowger JA, Naka Y, Aaronson KD, Horstmanshof D, Gulati S, Rinde-Hoffman D, Pinney S, Adatya S, Farrar DJ, Jorde UP. Quality of life and functional capacity outcomes in the MOMENTUM 3 trial at 6 months: A call for new metrics for left ventricular assist device patients. J Heart Lung Transplant 2018; 37:15-24. [DOI: 10.1016/j.healun.2017.10.019] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 10/03/2017] [Accepted: 10/18/2017] [Indexed: 10/18/2022] Open
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18
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Quality of life of family caregivers of patients with a left ventricular assist device in Japan. J Cardiol 2018; 71:81-87. [DOI: 10.1016/j.jjcc.2017.06.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 05/17/2017] [Accepted: 06/06/2017] [Indexed: 01/31/2023]
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19
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Readmissions after continuous flow left ventricular assist device implantation. J Artif Organs 2017; 20:311-317. [DOI: 10.1007/s10047-017-0975-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 07/20/2017] [Indexed: 10/19/2022]
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20
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Dunlay SM, Strand JJ, Wordingham SE, Stulak JM, Luckhardt AJ, Swetz KM. Dying With a Left Ventricular Assist Device as Destination Therapy. Circ Heart Fail 2017; 9:CIRCHEARTFAILURE.116.003096. [PMID: 27758809 DOI: 10.1161/circheartfailure.116.003096] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 09/02/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Despite the ability of left ventricular assist device as destination therapy (DT-LVAD) to prolong survival for many patients with advanced heart failure, little is known about the eventual end-of-life care that patients with DT-LVAD receive. METHODS AND RESULTS All patients undergoing DT-LVAD at the Mayo Clinic in Rochester, Minnesota, from January 1, 2007, to September 30, 2014, who subsequently died before July 1, 2015, were included. Information about end-of-life care was obtained from documentation in the electronic medical record. Of 89 patients who died with a DT-LVAD, the median (25th-75th percentile) time from left ventricular assist device implantation to death was 14 (4-31) months. The most common causes of death were multiorgan failure (26%), hemorrhagic stroke (24%), and progressive heart failure (21%). Nearly half (46%) of the patients saw palliative care within 1 month before death; however, only 13 (15%) patients enrolled in hospice a median 11 (range 1-315) days before death. Most patients (78%) died in the hospital, of which 88% died in the intensive care unit. In total, 49 patients had their left ventricular assist device deactivated before death, with all but 3 undergoing deactivation in the hospital. Most patients died within an hour of left ventricular assist device deactivation and all within 26 hours. CONCLUSIONS In contrast to the general heart failure population, most patients with DT-LVAD die in the hospital and few use hospice. Further work is needed to understand these differences and to determine whether patients with DT-LVAD are receiving optimal end-of-life care.
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Affiliation(s)
- Shannon M Dunlay
- From the Department of Cardiovascular Diseases (S.M.D.), the Division of Health Care Policy and Research, Department of Health Sciences Research (S.M.D.), the Division of General Internal Medicine, Department of Medicine (J.J.S.), and the Division of Cardiovascular Surgery, Department of Surgery (J.M.S., A.J.L.), Mayo Clinic, Rochester, MN; Division of Hematology & Medical Oncology, Department of Internal Medicine, Mayo Clinic, Phoenix, AZ (S.E.W.); and Department of Medicine and Center for Palliative & Supportive Care, University of Alabama Birmingham, and the Birmingham Veterans Affairs Medical Center, AL (K.M.S.).
| | - Jacob J Strand
- From the Department of Cardiovascular Diseases (S.M.D.), the Division of Health Care Policy and Research, Department of Health Sciences Research (S.M.D.), the Division of General Internal Medicine, Department of Medicine (J.J.S.), and the Division of Cardiovascular Surgery, Department of Surgery (J.M.S., A.J.L.), Mayo Clinic, Rochester, MN; Division of Hematology & Medical Oncology, Department of Internal Medicine, Mayo Clinic, Phoenix, AZ (S.E.W.); and Department of Medicine and Center for Palliative & Supportive Care, University of Alabama Birmingham, and the Birmingham Veterans Affairs Medical Center, AL (K.M.S.)
| | - Sara E Wordingham
- From the Department of Cardiovascular Diseases (S.M.D.), the Division of Health Care Policy and Research, Department of Health Sciences Research (S.M.D.), the Division of General Internal Medicine, Department of Medicine (J.J.S.), and the Division of Cardiovascular Surgery, Department of Surgery (J.M.S., A.J.L.), Mayo Clinic, Rochester, MN; Division of Hematology & Medical Oncology, Department of Internal Medicine, Mayo Clinic, Phoenix, AZ (S.E.W.); and Department of Medicine and Center for Palliative & Supportive Care, University of Alabama Birmingham, and the Birmingham Veterans Affairs Medical Center, AL (K.M.S.)
| | - John M Stulak
- From the Department of Cardiovascular Diseases (S.M.D.), the Division of Health Care Policy and Research, Department of Health Sciences Research (S.M.D.), the Division of General Internal Medicine, Department of Medicine (J.J.S.), and the Division of Cardiovascular Surgery, Department of Surgery (J.M.S., A.J.L.), Mayo Clinic, Rochester, MN; Division of Hematology & Medical Oncology, Department of Internal Medicine, Mayo Clinic, Phoenix, AZ (S.E.W.); and Department of Medicine and Center for Palliative & Supportive Care, University of Alabama Birmingham, and the Birmingham Veterans Affairs Medical Center, AL (K.M.S.)
| | - Angela J Luckhardt
- From the Department of Cardiovascular Diseases (S.M.D.), the Division of Health Care Policy and Research, Department of Health Sciences Research (S.M.D.), the Division of General Internal Medicine, Department of Medicine (J.J.S.), and the Division of Cardiovascular Surgery, Department of Surgery (J.M.S., A.J.L.), Mayo Clinic, Rochester, MN; Division of Hematology & Medical Oncology, Department of Internal Medicine, Mayo Clinic, Phoenix, AZ (S.E.W.); and Department of Medicine and Center for Palliative & Supportive Care, University of Alabama Birmingham, and the Birmingham Veterans Affairs Medical Center, AL (K.M.S.)
| | - Keith M Swetz
- From the Department of Cardiovascular Diseases (S.M.D.), the Division of Health Care Policy and Research, Department of Health Sciences Research (S.M.D.), the Division of General Internal Medicine, Department of Medicine (J.J.S.), and the Division of Cardiovascular Surgery, Department of Surgery (J.M.S., A.J.L.), Mayo Clinic, Rochester, MN; Division of Hematology & Medical Oncology, Department of Internal Medicine, Mayo Clinic, Phoenix, AZ (S.E.W.); and Department of Medicine and Center for Palliative & Supportive Care, University of Alabama Birmingham, and the Birmingham Veterans Affairs Medical Center, AL (K.M.S.)
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Health-related quality of life prospectively evaluated by the 8-item short form after endovascular repair versus open surgery for abdominal aortic aneurysms. Heart Vessels 2017; 32:960-968. [DOI: 10.1007/s00380-017-0956-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 01/27/2017] [Indexed: 10/19/2022]
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22
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Vierecke J, Schweiger M, Feldman D, Potapov E, Kaufmann F, Germinario L, Hetzer R, Falk V, Krabatsch T. Emergency procedures for patients with a continuous flow left ventricular assist device. Emerg Med J 2016; 34:831-841. [DOI: 10.1136/emermed-2015-204912] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 08/19/2016] [Accepted: 09/23/2016] [Indexed: 11/03/2022]
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23
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Meng Y, Liu X, Liu J, Cheng X. A prospective study on the impact of heart rate control achieved with metoprolol on cardiac performance, motor function and quality of life in Chinese chronic heart failure patients. Int J Cardiol 2016; 227:267-271. [PMID: 27843047 DOI: 10.1016/j.ijcard.2016.11.115] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 11/06/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND To prospectively evaluate the impact of metoprolol achieved heart rate (HR) on cardiac-motor function and quality of life (QoL) in chronic heart failure (CHF) patients. METHODS AND RESULTS Between February 2013 to April 2016, association of HR reduction with haemodynamic indices, motor function and QoL in CHF patients with HR>80bpm receiving metoprolol 23.75mg or 47.5mgq.d was studied. Overall, 154 patients (median age, 66.39years; males, n=101; females, n=53) were enrolled, whose average resting HR decreased significantly from baseline value of 82.72±6.73 to 69.38±3.57, 67.72±2.61, 66.50±3.14 and 64.86±3.21bpm in the 1st, 3rd, 6th and 12th months post metoprolol intervention, respectively (P<0.0001). Similarly, the ejection fraction (r=-0.6461, P<0.0001), cardiac output (r=-0.5238, P<0.0001), cardiac index (r=-0.5378, P<0.0001) and veterans specific activity questionnaire scores (r=-0.4088, P<0.0001) were significantly associated with the reduction in HR after 12months. The improvement in 6-min walk test was independent of HR reduction (P=0.005). Similarly, QoL as measured by short form-8 questionnaire (SF-8) but not Minnesota Living with Heart Failure was significantly improved at the 12th-month. However, this was not associated with the reductions in HR. CONCLUSION Metoprolol achieved HR control was associated with improvement in cardiac performance and motor function but not QoL in patients with CHF.
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Affiliation(s)
- Yong Meng
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan 650101, China.
| | - Xuelu Liu
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan 650101, China
| | - Juan Liu
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan 650101, China
| | - Xianliang Cheng
- Department of Cardiology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Road, Kunming, Yunnan 650101, China
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