Quality of life metrics in LVAD patients after hemocompatibility-related adverse events

Matthew P. Weber, John Stulak, Simon Maltais, Francis D. Pagani, Jennifer Cowger, Vakhtang Tchantchaleishvili

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Hemocompatibility-related adverse events (HRAE) negatively influence survival. However, no study has examined the impact of these events on health-related quality of life (HRQOL) and functional outcomes following continuous-flow left ventricular assist device implantation (CF-LVAD). We assessed the impact of HRAE events on HRQOL and hypothesized that HRAE's adversely impact HRQOL and functional outcomes. Methods: INTERMACS database identified patients undergoing primary CF-LVAD implantation from 2008 to 2017. HRAEs included stroke, non-surgical bleeding, hemolysis, and pump thrombosis and were identified as defined in the literature. HRAEs were further stratified as Tier 1–2 and disabling stroke events. Time-series analysis was executed for HRAE patients with values pre-HRAE, post-HRAE, and closest to 12 months follow up. Local polynomial regression curves modeling individual patients were superimposed into “spaghetti” plots. Results: All HRQOL and functional metrics improved in patients over time, despite HRAE complications. However, these patient metrics were significantly reduced compared to the non-HRAE cohort. Advanced data visualization techniques noted a decline after experiencing an HRAE with a subsequent recovery to baseline levels or higher. Six-minute walk test (6MWT) was noted to be most affected in the post-HRAE period but recovered similar to other metrics. Conclusions: The burden of HRAE following CF-LVAD implantation did not negatively impact the quality of life. However, the 6MWT did not increase in the post-HRAE period in all HRAE patients. Improvement of heart failure symptoms after CF-LVAD coupled with optimal management following the HRAE act to preserve the enhanced quality of life.

Original languageEnglish (US)
JournalArtificial Organs
DOIs
StateAccepted/In press - 2022

Keywords

  • adverse events
  • heart failure
  • HRAE
  • left ventricular assist device
  • quality of life

ASJC Scopus subject areas

  • Bioengineering
  • Medicine (miscellaneous)
  • Biomaterials
  • Biomedical Engineering

Fingerprint

Dive into the research topics of 'Quality of life metrics in LVAD patients after hemocompatibility-related adverse events'. Together they form a unique fingerprint.

Cite this