Sandra B Lauck1, Suzanne V Arnold2, Britt Borregaard3, Janarthanan Sathananthan4, Karin H Humphries5, Suzanne J Baron6, Harindra C Wijeysundera7, Anita Asgar8, Robert Welsh9, James L Velianou10, John G Webb11, David A Wood4, David J Cohen12. 1. Centre for Heart Valve Innovation, St. Paul's Hospital, Vancouver, Canada. Electronic address: slauck@providencehealth.bc.ca. 2. Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, MO, USA. 3. Department of Cardiology, Odense University Hospital, Odense, Denmark. 4. Centre for Heart Valve Innovation, St. Paul's Hospital, Vancouver, Canada; Vancouver General Hospital, Vancouver, Canada. 5. BC Centre for Improved Cardiovascular Health, St. Paul's Hospital, Vancouver, Canada. 6. Lahey Hospital & Medical Center, Burlington, MA, USA. 7. Sunnybrook Health Sciences Centre, Toronto, Canada. 8. Montreal Heart Institute, Montreal, Canada. 9. Mazankowski Alberta Heart Institute, Edmonton, Canada. 10. Hamilton Health Sciences, McMaster University, Hamilton, Canada. 11. Centre for Heart Valve Innovation, St. Paul's Hospital, Vancouver, Canada. 12. University of Missouri-Kansas City, Kansas City, MO, USA.
Abstract
BACKGROUND: Patients with severe, symptomatic aortic stenosis derive substantial 30-day quality of life (QOL) benefit from transcatheter aortic valve replacement (TAVR). Whether the QOL benefit of TAVR emerges earlier is unknown. We used data from the Multimodality, Multidisciplinary but Minimalist (3M) TAVR study to assess early changes in QOL after transfemoral (TF) TAVR. METHODS: Health status was assessed at baseline, 2-weeks, 30-days, and 1-year after TAVR using the Kansas City Cardiomyopathy Questionnaire (KCCQ) and Medical Outcomes Study Short-Form 12 (SF-12). The KCCQ overall summary (KCCQ-OS) score (range 0-100; higher scores = better health) was the primary health status outcome. Linear mixed effects models were used to describe trajectories of QOL scores over time. A good outcome was defined as being "alive and well", with a KCCQ-OS score ≥ 60 points with no decrease from baseline ≥10 points. RESULTS: A total of 358 patients (87.1%) completed the baseline and at least one follow-up survey. Between baseline and 2-weeks, the KCCQ-OS increased by 21.3 points (95% confidence interval [CI]: 19.3-23.2). This improvement was sustained over time with only slight further improvement between 2-weeks and 1-month (3.4 points; 95% CI: 1.4 to 5.5) and no significant change between 1-month and 1-year (1.9 points; 95% CI: -0.2 to 4.1). Scores for the KCCQ subscales and SF-12 physical and mental component summary scales showed a similar pattern. Most patients (74.4%) were "alive and well" at 2 weeks with similar rates at 1-month and 1-year (79.5% and 77.3%, respectively). CONCLUSIONS: Among patients undergoing TF-TAVR, both disease-specific and generic health status improved substantially within the first 2 weeks, with only minimal further improvement thereafter.
BACKGROUND:Patients with severe, symptomatic aortic stenosis derive substantial 30-day quality of life (QOL) benefit from transcatheter aortic valve replacement (TAVR). Whether the QOL benefit of TAVR emerges earlier is unknown. We used data from the Multimodality, Multidisciplinary but Minimalist (3M) TAVR study to assess early changes in QOL after transfemoral (TF) TAVR. METHODS: Health status was assessed at baseline, 2-weeks, 30-days, and 1-year after TAVR using the Kansas City Cardiomyopathy Questionnaire (KCCQ) and Medical Outcomes Study Short-Form 12 (SF-12). The KCCQ overall summary (KCCQ-OS) score (range 0-100; higher scores = better health) was the primary health status outcome. Linear mixed effects models were used to describe trajectories of QOL scores over time. A good outcome was defined as being "alive and well", with a KCCQ-OS score ≥ 60 points with no decrease from baseline ≥10 points. RESULTS: A total of 358 patients (87.1%) completed the baseline and at least one follow-up survey. Between baseline and 2-weeks, the KCCQ-OS increased by 21.3 points (95% confidence interval [CI]: 19.3-23.2). This improvement was sustained over time with only slight further improvement between 2-weeks and 1-month (3.4 points; 95% CI: 1.4 to 5.5) and no significant change between 1-month and 1-year (1.9 points; 95% CI: -0.2 to 4.1). Scores for the KCCQ subscales and SF-12 physical and mental component summary scales showed a similar pattern. Most patients (74.4%) were "alive and well" at 2 weeks with similar rates at 1-month and 1-year (79.5% and 77.3%, respectively). CONCLUSIONS: Among patients undergoing TF-TAVR, both disease-specific and generic health status improved substantially within the first 2 weeks, with only minimal further improvement thereafter.
Authors: Lizette N Abraham; Kirstine L Sibilitz; Selina K Berg; Lars H Tang; Signe S Risom; Jane Lindschou; Rod S Taylor; Britt Borregaard; Ann-Dorthe Zwisler Journal: Cochrane Database Syst Rev Date: 2021-05-07
Authors: Sandra B Lauck; Maggie Yu; Lillian Ding; Sean Hardiman; Daniel Wong; Janarthanan Sathananthan; Jian Ye; Albert Chan; Steven Hodge; Simon Robinson; David A Wood; John G Webb Journal: CJC Open Date: 2021-04-24
Authors: Simon Kennon; Rima Styra; Nikolaos Bonaros; Lukas Stastny; Mauro Romano; Thierry Lefèvre; Carlo Di Mario; Pierluigi Stefàno; Flavio Luciano Ribichini; Dominique Himbert; Marina Urena-Alcazar; Jorge Salgado-Fernandez; Jose Joaquin Cuenca Castillo; Bruno Garcia; Cornelia Deutsch; Lenka Sykorova; Jana Kurucova; Martin Thoenes; Claudia Lüske; Peter Bramlage; Derk Frank Journal: Open Heart Date: 2021-11
Authors: Sandra B Lauck; Suzanne J Baron; William Irish; Britt Borregaard; Kimberly A Moore; Candace L Gunnarsson; Seth Clancy; David A Wood; Vinod H Thourani; John G Webb; Harindra C Wijeysundera Journal: J Am Heart Assoc Date: 2021-09-28 Impact factor: 5.501