Self-Reported Physical Health with a Left Ventricular Assist Device: Findings from the Mechanical Circulatory Support Measures of Adjustment and Quality of Life (MCS A-QOL) Study

• Published in: The Journal of heart and lung transplantation Vol. 38; no. 4; pp. S437 - S438
• Main Authors: Grady, K.L., Jackson, K., Wortman, K., Buono, S., Beiser, D., Murks, C., Lee, C., Denfeld, Q., Lindenfeld, J., Rich, J., Yancy, C., Pham, D., Cella, D., Goetz, P., Bannerjee, D., Kiernan, M., McIlvennan, C., Allen, L., Klein, L., Walsh, M., Ruo, B., Kallen, M., Hahn, E.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.04.2019
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2019.01.1117

Physical health among patients (pts) with advanced heart failure (HF) who undergo continuous flow left ventricular assist device (CF-LVAD) implantation is incompletely described, especially long-term. Research is needed to identify pts at risk. This report compared physical health early (≤ 6 months), mid (>6-24 months), and later (> 24 months) after CF-LVAD implantation. Using a cross-sectional design, we evaluated data from 250 pts with CF-LVADs who were ≥ 3 months post implant at 9 U.S. sites from 10/26/16 - 06/28/18. Measures of physical health included overall physical health (PROMIS, v1.1), physical function (PROMIS, v1.2), sleep disturbance (PROMIS, v1.0), sleep-related impairment (PROMIS, v1.0), and satisfaction with sexual function (PROMIS, v2.0, modified). Analyses included χ2 tests and ANOVAs. The majority of pts were male, white, and well educated; age differed by time period post implant. Etiology of HF and pre implant strategy were similar among groups. The majority of pts in all 3 groups reported fair to good overall physical health, although significant differences were detected by group. For all 3 groups, sleep disturbance and sleep-related impairment scores approximated the U.S. general population mean of 50, while physical function scores were about one standard deviation lower. A majority of pts in all groups were not satisfied with sexual function, and most reported that LVAD equipment affected their satisfaction adversely. See table. Regardless of time since implant, while the majority of pts reported overall physical health as fair or good, self-reported physical function was lower than the U.S. population and LVAD equipment interfered with satisfaction with sexual function. These findings highlight the importance of assessing multiple indicators of physical health and may provide direction for physical health focused therapies after CF-LVAD implantation.