Sophie Elmalem1, Nicolas Dumonteil2, Bertrand Marcheix2, Olivier Toulza3, Bruno Vellas4, Didier Carrie2, Fati Nourhashemi4. 1. Gérontopôle, Service de Médecine Interne Gériatrique du Pr B. Vellas, CHU Toulouse Hôpital Casselardit, Toulouse, France. Electronic address: elmalem.s@chu-toulouse.fr. 2. Pôle Cardiovasculaire et Métabolique, CHU Hopital Rangueil, Toulouse, France. 3. Gérontopôle, Service de Médecine Interne Gériatrique du Pr B. Vellas, CHU Toulouse Hôpital Casselardit, Toulouse, France. 4. Gérontopôle, Service de Médecine Interne Gériatrique du Pr B. Vellas, CHU Toulouse Hôpital Casselardit, Toulouse, France; Inserm U1027, Toulouse, France.
Abstract
BACKGROUND: Severe aortic stenosis may affect both normal daily living and survival. Transcatheter aortic valve implantation (TAVI) has become an appropriate alternative to surgery for elderly patients with high surgical risk, and it results in improved survival in this population. OBJECTIVE: To describe health-related quality of life (QoL) before, and at 1 and 6 months after TAVI. SETTING: Cardiovascular Department, Toulouse University Hospital, France. METHODS: One hundred sixty-four consecutive patients with at least 6 months follow-up who underwent TAVI in our institution between February 2009 and June 2011 were enrolled in the study. Of this population, 73 (mean age: 82.3 ± 7.3 years, 56% men) completed QoL assessment using the EuroQOL Five Dimensions (EQ-5D) questionnaire and a visual analogue scale at baseline, and at 1 and 6 months. At each visit, medical data and New York Heart Association functional class were collected. RESULTS: The median preprocedure EQ-5D index value (interquartile range) was 0.66 (range, 0.36-0.78) showing severely impaired QoL in almost all patients. Significant improvement occurred from baseline to 1 month of follow-up in EQ-5D index value [0.73 (range, 0.59-0.79)] and this was maintained at 0.73 (range, 0.62-0.81) at 6 months. The improvement was significant for 3 dimensions of the EQ-5D score at the 6-month follow-up: usual activities in 43.8% of patients (P < .001); anxiety/depression in 37% (P < .001) and pain/discomfort in 28.8% (P < .05). Mean New York Heart Association class improved significantly from 3.24 at baseline to 2.04 at 1 month and 1.89 at 6 months. CONCLUSIONS: In high-risk patients with severe aortic stenosis, QoL and health status improved substantially at 1 month and improvement persisted 6 months after TAVI.
BACKGROUND: Severe aortic stenosis may affect both normal daily living and survival. Transcatheter aortic valve implantation (TAVI) has become an appropriate alternative to surgery for elderly patients with high surgical risk, and it results in improved survival in this population. OBJECTIVE: To describe health-related quality of life (QoL) before, and at 1 and 6 months after TAVI. SETTING: Cardiovascular Department, Toulouse University Hospital, France. METHODS: One hundred sixty-four consecutive patients with at least 6 months follow-up who underwent TAVI in our institution between February 2009 and June 2011 were enrolled in the study. Of this population, 73 (mean age: 82.3 ± 7.3 years, 56% men) completed QoL assessment using the EuroQOL Five Dimensions (EQ-5D) questionnaire and a visual analogue scale at baseline, and at 1 and 6 months. At each visit, medical data and New York Heart Association functional class were collected. RESULTS: The median preprocedure EQ-5D index value (interquartile range) was 0.66 (range, 0.36-0.78) showing severely impaired QoL in almost all patients. Significant improvement occurred from baseline to 1 month of follow-up in EQ-5D index value [0.73 (range, 0.59-0.79)] and this was maintained at 0.73 (range, 0.62-0.81) at 6 months. The improvement was significant for 3 dimensions of the EQ-5D score at the 6-month follow-up: usual activities in 43.8% of patients (P < .001); anxiety/depression in 37% (P < .001) and pain/discomfort in 28.8% (P < .05). Mean New York Heart Association class improved significantly from 3.24 at baseline to 2.04 at 1 month and 1.89 at 6 months. CONCLUSIONS: In high-risk patients with severe aortic stenosis, QoL and health status improved substantially at 1 month and improvement persisted 6 months after TAVI.
Authors: Maisha M Khan; Krista L Lanctôt; Stephen E Fremes; Harindra C Wijeysundera; Sam Radhakrishnan; Damien Gallagher; Dov Gandell; Megan C Brenkel; Elias L Hazan; Natalia G Docteur; Nathan Herrmann Journal: Clin Interv Aging Date: 2019-05-08 Impact factor: 4.458