Author + information
- Klaudia Vivien Nagy,
- Gábor Széplaki,
- András M. Boros,
- Péter Perge,
- Astrid Apor,
- Annamária Kosztin,
- Levente Molnár,
- László Gellér and
- Bela Merkely
Background: There are previous studies about the prognostic significance of quality of life (QoL) in CRT-implanted patients measured with complex heart failure questionnaires. However, there is no data with the EuroQol-5 Dimensions (EQ-5D) questionnaire, which provides a simple descriptive profile of health status. We aimed to assess the predictive role of baseline QoL and QoL change at 6 months after CRT implant with EQ-5D on 5 years mortality and response.
Methods: Consecutive HF patients (n=130) were enrolled prospectively. All patients underwent clinical evaluation and echocardiography before and 6 months after CRT and followed up for 5 years. Subjects filled out the EQ-5D questionnaire prior to and 6 months after CRT. CRT-response was defined at 6 months as 15% reduction in LV end-systolic volume.
Results: 54 patients (41.5%) died during the 5 years follow up. 85 (65.3%) patients were considered clinical and 63 (48.5%) echocardiographic responders to CRT. There was significant improvement in usual activities in 93 (71.5%, p=0.03), pain in 92 (70.7%, p=0.03) patients and health status based on visual analogue scale [50.0% (35.0-65.0) vs. 60.0% (50.0-75.0), p<0.001] also improved at 6 months. During multivariate Cox analysis regarding clinical response, problems with mobility before implant was associated with lower response rate [OR=0.36 (0.16-0.84), p=0.018], however echocardiographic response was lower in those who had problems with self-care at baseline [OR=0.10 (0.01-0.94), p=0.04]. In multivariate Cox regression only those patients who had problems with self-care [HR=2.39 (1.17-4.86), p=0.01] and had more anxiety [HR=1.51 (1.00-2.26), p=0.04] at baseline had poor long term survival. At 6 months follow-up, improvement in mobility [HR: 3.95 (1.89-8.20), p<0.001], self-care [HR: 7.69 (2.23-25.9), p=0.001] and VAS scale [HR: 2.24 (1.27-3.94), p=0.005] had significantly better survival during the 5 years follow-up.
Conclusions: The EQ-5D health questionnaire is an easy obtainable method to assess QoL and predict outcome in this severely ill patient population. Therefore, it may be considered to include this simple measure in patient selection and follow-up care.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Heart Failure and Cardiomyopathies: Heart Failure Gadgets Galore
Abstract Category: 14. Heart Failure and Cardiomyopathies: Therapy
Presentation Number: 1199-252
- 2017 American College of Cardiology Foundation