Change in quality of life from after left ventricular assist device implantation to after heart transplantation.
BACKGROUND
No studies have analyzed quality of life (QOL) from before to after heart transplantation in patients with a left ventricular assist device (LVAD). Therefore, the purpose of this longitudinal, multi-site study was to compare QOL outcomes of patients listed for heart transplantation who required a left ventricular assist device (LVAD) at 3 months after implantation of an LVAD vs 3 months after heart transplantation.


METHODS
A non-random sample of 40 patients (predominantly middle-aged, married, white men), who had paired data at both 3 months after LVAD implantation and 3 months after heart transplantation, were investigated. Patients completed self-report questionnaires (with acceptable reliability and validity) at both time periods, including the Quality of Life Index, Rating Question Form, Heart Failure Symptom Checklist, Sickness Impact Profile, LVAD Stressor Scale (completed only after LVAD implant), Heart Transplant Stressor Scale (completed only after heart transplant) and Jalowiec Coping Scale. Descriptive analyses and comparative analyses using paired t-tests were performed with statistical significance set at 0.01.


RESULTS
Patients were significantly more satisfied with their lives overall and with their health and functioning at 3 months after heart transplantation as compared with 3 months after LVAD implantation. Mobility, self-care ability, physical ability and overall functional ability improved from 3 months after LVAD implant to 3 months after heart transplant. There was significantly less symptom distress after LVAD implant as compared with after heart transplant for the neurologic, dermatologic and physical sub-scales. Work/school/financial stress was significantly lower after heart transplant vs after LVAD implant. In contrast, 2 other areas of stress were significantly lower after LVAD implant vs after heart transplant: self-care stress and hospital/clinic-related stress.


CONCLUSIONS
Differences were found in QOL outcomes at 3 months after LVAD implant as compared with 3 months after heart transplant. Our findings point out specific areas of concern with respect to QOL after LVAD implant and post-transplant, some of which are amenable to health-care provider interventions.
Section of Cardiology, Rush Heart Failure and Cardiac Transplant Program, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612-3824, USA.
Kathleen L
KL
Grady
Peter M
PM
Meyer
Diane
D
Dressler
Connie
C
White-Williams
Annemarie
A
Kaan
Annette
A
Mattea
Sophia
S
Ormaza
Suzanne
S
Chillcott
Alice
A
Loo
Barbara
B
Todd
Maria Rosa
MR
Costanzo
William
W
Piccione
D000328:Adult; D000368:Aged; D001315:Australia; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000523:psychology*; D006353:Heart-Assist Devices / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014481:United States; D014850:Waiting Lists