Health-related quality of life in elderly patients with heart failure

By Samar Mahmoud, MS
Published February 20, 2022

Key Takeaways

  • This observational, multi-center study found that health-related quality of life (HRQOL) was poor to fair in older patients with advanced heart failure. 

  • Investigators found that patients who were not eligible for a heart transplant and were scheduled for implantation of long-term mechanical circulatory support had worse HRQOL than patients who were eligible for waiting for a heart transplant with or without mechanical circulatory support. 

  • Understanding HRQOL differences is critical to guiding treatment decisions toward more personalized heart failure therapies.

HF affects approximately 6.2 million adults in the US. Mortality in patients with HF is high and is even higher for patients with advanced HF. Treatment plans for these patients include interventions to not only improve survival but to also improve HRQOL.

Why This Study Matters 

Research evaluating HRQOL in older patients with advanced heart failure is limited. To fill this gap, this study sought to compare HRQOL among groups of older patients with heart failure before heart transplantation (HT) or long-term mechanical circulatory support (MCS).

Study Design 

This study used data from the Sustaining Quality of Life of the Aged: Heart Transplant or Mechanical Support (SUSTAIN-IT) study.  Patients were classified into 3 groups: HT candidates with MCS, HT candidates without MCS, and candidates not eligible for HT and scheduled for long-term MCS. Study participants complete assessments on self-reported measures of HRQOL, depressive symptoms, anxiety, cognitive status, and performance-based measures. 

Results and Conclusions

The study included 393 patients, with a majority of participants being White men. Long-term MCS candidates had worse HRQOL than HT candidates, irrespective of MCS status. After multiple variable adjustments, researchers found that the following factors were associated with worse overall HRQOL: lower 6-minute walk distance, higher New York Heart Association class, depressive symptoms, and not being an HT candidate with MCS.

Related Research

Consider these findings from similar research studies:

  • HRQOL improved from before implantation to 2 years after MCS implant, irrespective of implant strategy (Source). 

  • HRQOL is a predictor of long-term cardiac death in older patients hospitalized with HF (Source).

Original Source 

Grady KL, Andrei A, Elenbaas C, et al. Health‐related quality of life in older patients with advanced heart failure: findings from the sustain‐it study. JAHA. 2022;11(4):e024385.

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