1. Quality of life measured with EuroQol-five dimensions questionnaire predicts long-term mortality, response, and reverse remodelling in cardiac resynchronization therapy patients
- Author
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Endre Zima, Klaudia Vivien Nagy, Tamás Tahin, Levente Molnár, Valentina Kutyifa, Béla Merkely, Astrid Apor, László Gellér, András Mihály Boros, Annamaria Kosztin, Gábor Széplaki, Szabolcs Szilágyi, and Péter Perge
- Subjects
Male ,Survival ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Anxiety ,Cardiac Resynchronization Therapy ,0302 clinical medicine ,Quality of life ,Surveys and Questionnaires ,Activities of Daily Living ,Clinical endpoint ,Odds Ratio ,030212 general & internal medicine ,Prospective Studies ,education.field_of_study ,Ventricular Remodeling ,Depression ,Hazard ratio ,Middle Aged ,Prognosis ,Treatment Outcome ,Echocardiography ,Cardiac resynchronisation therapy ,Female ,Medical emergency ,Cardiology and Cardiovascular Medicine ,medicine.medical_specialty ,Visual analogue scale ,Population ,Bundle-Branch Block ,Cardiac resynchronization therapy ,Pain ,03 medical and health sciences ,Clinical Research ,Pacing and Cardiac Resynchronization Therapy ,Physiology (medical) ,Internal medicine ,medicine ,Humans ,Mobility Limitation ,Mortality ,education ,Reverse remodelling ,Aged ,Proportional Hazards Models ,Heart Failure ,business.industry ,EQ-5D ,Responder ,Odds ratio ,medicine.disease ,Heart failure ,business ,Follow-Up Studies - Abstract
Aims There are previous studies on quality of life (QoL) in cardiac resynchronization therapy (CRT) patients; however, there are no data with the short EuroQol-five dimensions (EQ-5D) questionnaire predicting outcomes. We aimed to assess the predictive role of baseline QoL and QoL change at 6 months after CRT with EQ-5D on 5-year mortality and response. Methods and results In our prospective follow-up study, 130 heart failure (HF) patients undergoing CRT were enrolled. Clinical evaluation, echocardiography, and EQ-5D were performed at baseline and at 6 months of follow–up, continued to 5 years. Primary endpoint was all-cause mortality at 5 years. Secondary endpoints were (i) clinical response with at least one class improvement in New York Heart Association without HF hospitalization and (ii) reverse remodelling with 15% reduction in left ventricular end-systolic volume at 6 months. Fifty-four (41.5%) patients died during 5 years, 85 (65.3%) clinical responders were identified, and 63 patients (48.5%) had reverse remodelling. Baseline issues with mobility were associated with lower response [odds ratio (OR) 0.36, 95% confidence interval (CI) 0.16–0.84; P = 0.018]. Lack of reverse remodelling correlated with self-care issues at baseline (OR 0.10, 95% CI 0.01–0.94; P = 0.04). Furthermore, self-care difficulties [hazard ratio (HR) 2.39, 95% CI 1.17–4.86; P = 0.01) or more anxiety (HR 1.51, 95% CI 1.00–2.26; P = 0.04) predicted worse long-term survival. At 6 months, mobility (HR 3.95, 95% CI 1.89–8.20; P
- Published
- 2017