Distinct trajectories of disease-specific health status in heart failure patients undergoing cardiac resynchronization therapy

Distinct trajectories of disease-specific health status in heart failure patients undergoing cardiac resynchronization therapy

Purpose It is well known that a significant proportion of heart failure patients (10-44 %) do not show improvement in symptoms or functioning from cardiac resynchronization therapy (CRT), yet no study has examined patient-reported health status trajectories after implantation. Methods A cohort of 13...

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Veröffentlicht in:Quality of Life Research. - Springer Science + Business Media. - 25(2016), 6, Seite 1451-1460
1. Verfasser: Mastenbroek, Mirjam H. (VerfasserIn)
Weitere Verfasser: Pedersen, Susanne S., Meine, Mathias, Versteeg, Henneke
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2016
Zugriff auf das übergeordnete Werk:Quality of Life Research
Schlagworte:Health sciences Behavioral sciences
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100 1 |a Mastenbroek, Mirjam H.  |e verfasserin  |4 aut 
245 1 0 |a Distinct trajectories of disease-specific health status in heart failure patients undergoing cardiac resynchronization therapy 
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520 |a Purpose It is well known that a significant proportion of heart failure patients (10-44 %) do not show improvement in symptoms or functioning from cardiac resynchronization therapy (CRT), yet no study has examined patient-reported health status trajectories after implantation. Methods A cohort of 139 patients with a CRT-defibrillator (70 % men; age 65.7 ± 10.1 years) completed the Kansas City Cardiomyopathy Questionnaire (KCCQ) prior to implantation (baseline) and at 2, 6, and 12-14 months post-implantation. Latent class analyses were used to identify trajectories and associates of disease-specific health status over time. Results All health status trajectories showed an initial small to large improvement from baseline to 2-month follow-up, whereafter most trajectories displayed a stable pattern between short- and long-term follow-up. Low educational level, NYHA class III/IV, smoking, no use of beta-blockers, use of psychotropic medication, anxiety, depression, and type D personality were found to be associated with poorer health status in unadjusted analyses. Interestingly, subgroups of patients (12-20 %) who experienced poor health status at baseline improved to stable good health status levels after implantation. Conclusions Levels of disease-specific health status vary considerably across subgroups of CRT-D patients. Classification into poorer disease-specific health status trajectories was particularly associated with patients' psychological profile and NYHA classification. The timely identification of CRT-D patients who present with poor disease-specific health status (i.e., KCCQ score < 50) and a distressed psychological profile (i.e., anxiety, depression, and/or type D personality) is paramount, as they may benefit from cardiac rehabilitation in combination with psychological intervention. 
540 |a © Springer International Publishing 2016 
650 4 |a Health sciences  |x Health and wellness  |x Health status 
650 4 |a Behavioral sciences  |x Sociology  |x Human societies  |x Social structures  |x Social stratification  |x Social classes 
650 4 |a Health sciences  |x Health and wellness  |x Health status  |x Quality of life 
650 4 |a Behavioral sciences  |x Psychology  |x Personality psychology 
650 4 |a Health sciences  |x Health and wellness  |x Physical health 
650 4 |a Health sciences  |x Health and wellness  |x Public health  |x Epidemiology  |x International Statistical Classification of Diseases 
650 4 |a Behavioral sciences  |x Psychology  |x Clinical psychology  |x Mental illness  |x Mood disorders  |x Depressive disorders 
650 4 |a Health sciences  |x Medical sciences  |x Medical technology  |x Implants  |x Artificial organs  |x Artificial pacemakers 
650 4 |a Health sciences  |x Medical conditions  |x Diseases  |x Cardiovascular diseases  |x Heart diseases  |x Congestive heart failure 
650 4 |a Health sciences  |x Medical treatment  |x Electric stimulation therapy  |x Artificial cardiac pacing  |x Cardiac resynchronization therapy  |x CLINICAL AND POLICY APPLICATIONS 
655 4 |a research-article 
700 1 |a Pedersen, Susanne S.  |e verfasserin  |4 aut 
700 1 |a Meine, Mathias  |e verfasserin  |4 aut 
700 1 |a Versteeg, Henneke  |e verfasserin  |4 aut 
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773 1 8 |g volume:25  |g year:2016  |g number:6  |g pages:1451-1460 
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