Continuous flow left ventricular assist device improves functional capacity and quality of life of advanced heart failure patients.
OBJECTIVE
This study sought to assess the impact of continuous flow left ventricular assist devices (LVADs) on functional capacity and heart failure-related quality of life.


BACKGROUND
Newer continuous-flow LVAD are smaller and quieter than pulsatile-flow LVADs.


METHODS
Data from advanced heart failure patients enrolled in the HeartMate II LVAD (Thoratec Corporation, Pleasanton, California) bridge to transplantation (BTT) (n = 281) and destination therapy (DT) (n = 374) trials were analyzed. Functional status (New York Heart Association [NYHA] functional class, 6-min walk distance, patient activity scores), and quality of life (Minnesota Living With Heart Failure [MLWHF] and Kansas City Cardiomyopathy Questionnaires [KCCQ]) were collected before and after LVAD implantation.


RESULTS
Compared with baseline, LVAD patients demonstrated early and sustained improvements in functional status and quality of life. Most patients had NYHA functional class IV symptoms at baseline. Following implant, 82% (BTT) and 80% (DT) of patients at 6 months and 79% (DT) at 24 months improved to NYHA functional class I or II. Mean 6-min walk distance in DT patients was 204 m in patients able to ambulate at baseline, which improved to 350 and 360 m at 6 and 24 months. There were also significant and sustained improvements from baseline in both BTT and DT patients in median MLWHF scores (by 40 and 42 U in DT patients, or 52% and 55%, at 6 and 24 months, respectively), and KCCQ overall summary scores (by 39 and 41 U, or 170% and 178%).


CONCLUSIONS
Use of a continuous flow LVAD in advanced heart failure patients results in clinically relevant improvements in functional capacity and heart failure-related quality of life.
Rogers
Joseph G
JG
Duke University Medical Center, Durham, NC 27710, USA. joseph.rogers@duke.edu
Aaronson
Keith D
KD
Boyle
Andrew J
AJ
Russell
Stuart D
SD
Milano
Carmelo A
CA
Pagani
Francis D
FD
Edwards
Brooks S
BS
Park
Soon
S
John
Ranjit
R
Conte
John V
JV
Farrar
David J
DJ
Slaughter
Mark S
MS
D004867:Equipment Design; D005260:Female; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy*; D006352:Heart Ventricles; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016138:Walking / Q000502:physiology