title: Health-related quality of life in hypertrophic cardiomyopathy patients with implantable defibrillators.
abstract: BACKGROUND
  Health-related quality of life (HRQL) in hypertrophic cardiomyopathy (HCM) patients with implantable cardioverter-defibrillators (ICDs) is largely unknown. The aim was to assess HRQL, including comparisons between groups, using the questionnaire SF-36, and compare it to a Swedish age- and sex-matched population.
  
  
  RESULTS
  Validated data on adult HCM patients with ICDs were used. The SF-36 response rate was 82.5 % and 245 patients (mean age 55.9 years, 70.2 % men) were analyzed using the Mann-Whitney U-test, t-test, Spearman correlation and effect size calculations. In all SF-36 domains the patients' score was lower (p-value of <0.0001) than norms except for bodily pain. The general health domain showed the highest effect size (0.77) and the impact was more pronounced in the SF-36 physical component summary score (0.62) than the mental component summary score (0.46). Older age was correlated with lower scores on the physical component and higher scores on the mental component. Atrial fibrillation and/or systolic heart failure were associated with worse physical health. HRQL was similar in primary vs secondary prevention cases. Inappropriate ICD shock was associated with worse mental health while appropriate therapy trended toward better mental health.
  
  
  CONCLUSIONS
  HCM patients with ICDs suffer from poor HRQL regardless of age, sex, or primary vs secondary prevention indication. Atrial fibrillation and systolic heart failure are determinants of poor physical health. Inappropriate shocks, but not appropriate therapies, are associated with poorer mental health.
authors.affiliation: Cardiology Research Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital/Solna, Stockholm, SE-171 76, Sweden. peter.magnusson@regiongavleborg.se.|Centre for Research and Development, Uppsala University/Region Gävleborg, Gävle, SE-801 87, Sweden. peter.magnusson@regiongavleborg.se.
authors.forename: Peter
authors.initials: P
authors.lastname: Magnusson
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Umeå, SE-90187, Sweden.
authors.forename: Stellan
authors.initials: S
authors.lastname: Mörner
authors.affiliation: Cardiology Research Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital/Solna, Stockholm, SE-171 76, Sweden.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Gadler
authors.affiliation: University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE-70182, Örebro, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Karlsson
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000628:therapy*; D002312:Cardiomyopathy, Hypertrophic / Q000628:therapy*; D015331:Cohort Studies; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D017147:Defibrillators, Implantable / Q000523:psychology*; D005260:Female; D054143:Heart Failure, Systolic / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D055502:Secondary Prevention; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013548:Sweden; D055815:Young Adult
keywords: Adult; Hypertrophic cardiomyopathy; Implantable cardioverter-defibrillator; Quality of life; SF-36