BACKGROUND The Registry Evaluation of Vital Information for Ventricular Assist Devices (VADs) in Ambulatory Life study is a prospective multicenter cohort of 400 ambulatory patients with advanced chronic systolic heart failure (HF). The aim of the study is to better understand disease trajectory and optimal timing of advanced HF therapies. We examined patient health-related quality of life (HRQOL) data collected at enrollment and their association with patient treatment preferences for VAD placement. METHODS Baseline assessment of HRQOL included the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the EuroQol EQ-5D-3L Visual Analogue Scale (VAS), along with patient self-assessment of remaining life (PSARL). Descriptive statistics were used to present baseline HRQOL data and Spearman correlation tests to assess the association between KCCQ, VAS, and VAD treatment preference with patient clinical characteristics of interest. RESULTS The median age was 60 years, 75% were male, and the median left ventricular ejection fraction was 20%. The median (25th percentile, 75th percentile), baseline KCCQ summary score was 64 (48, 78), VAS score 65 (50, 75), and PSARL 7 years (5, 10). There were statistically significant associations of baseline KCCQ and VAS with New York Heart Association class and Interagency Registry of Mechanically Assisted Circulatory Support profile (p < 0.005 for all comparisons). Baseline KCCQ and VAS revealed a modest association with PSARL (correlation = 0.45 and 0.35, respectively; p < 0.001), and many patients were overly optimistic about their expected survival. VAD treatment preference was associated with KCCQ scores (p < 0.031), but the absolute differences were small. VAD treatment preference was independent of other key clinical characteristics such as subject age, VAS, and PSARL. CONCLUSIONS We found a lack of strong association between HRQOL and patient preference for VAD therapy. Better understanding of patients' perceptions of their illness and how this relates to HRQOL outcomes, clinician risk assessment, and patient decision-making is needed. This may in turn allow better guidance toward available HF therapies in this vulnerable population.

中文翻译：

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动态晚期心力衰竭患者的生活质量和心室辅助装置治疗偏好：来自 REVIVAL 研究的报告。


背景 流动生活研究中心室辅助装置 (VAD) 重要信息的登记评估是一项前瞻性多中心队列，由 400 名患有晚期慢性收缩性心力衰竭 (HF) 的流动患者组成。该研究的目的是更好地了解疾病轨迹和先进心力衰竭治疗的最佳时机。我们检查了入组时收集的患者健康相关生活质量 (HRQOL) 数据及其与患者 VAD 安置治疗偏好的关系。方法 HRQOL 的基线评估包括堪萨斯城心肌病问卷 (KCCQ) 和 EuroQol EQ-5D-3L 视觉模拟量表 (VAS)，以及患者剩余寿命自我评估 (PSARL)。使用描述性统计数据呈现基线 HRQOL 数据和 Spearman 相关性检验，以评估 KCCQ、VAS 和 VAD 治疗偏好与感兴趣的患者临床特征之间的关联。结果 中位年龄为60岁，75%为男性，中位左心室射血分数为20%。中位数（第 25 个百分位数、第 75 个百分位数）、基线 KCCQ 总结评分为 64 (48, 78)，VAS 评分为 65 (50, 75)，PSARL 为 7 年 (5, 10)。基线 KCCQ 和 VAS 与纽约心脏协会分级和机械辅助循环支持机构间登记资料存在统计学显着相关性（所有比较的 p < 0.005）。基线 KCCQ 和 VAS 显示与 PSARL 存在适度关联（相关性分别 = 0.45 和 0.35；p < 0.001），并且许多患者对其预期生存过于乐观。 VAD 治疗偏好与 KCCQ 评分相关 (p < 0.031)，但绝对差异很小。 VAD 治疗偏好独立于其他关键临床特征，如受试者年龄、VAS 和 PSARL。结论 我们发现 HRQOL 与患者对 VAD 治疗的偏好之间缺乏强相关性。需要更好地了解患者对其疾病的看法以及这与 HRQOL 结果、临床医生风险评估和患者决策之间的关系。这反过来可能会为这一弱势群体提供更好的心力衰竭治疗指导。