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Martens S, Tie H, Scheld HH, Martens S, Hoffmeier A. Quality of Life After Heart Transplantation for Congenital Heart Defect. Transpl Int 2022; 35:10480. [PMID: 36274813 PMCID: PMC9583515 DOI: 10.3389/ti.2022.10480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 09/20/2022] [Indexed: 11/21/2022]
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Hartmann A, Heilmann C, Kaps J, Beyersdorf F, Zeh W, Albert W, Wirsching M, Fritzsche K, Joos A. Body image after heart transplantation compared to mechanical aortic valve insertion. Int J Psychiatry Clin Pract 2017; 21:277-282. [PMID: 28503975 DOI: 10.1080/13651501.2017.1324034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Heart transplantation (HT) obviously affects body image and integrity. However, there are very few empirical data post-transplant. METHODS In a cross-sectional study, 57 HT patients were compared with 47 subjects with mechanical aortic valve replacement (AVR) using the Dresden-Body-Image questionnaire (DKB) and specific questions regarding integration of the organ/device. In addition, affective symptoms and quality of life (QoL) were assessed (12-Item Short-Form Health Survey and Hospital Anxiety and Depression Scale, HADS). RESULTS DKB-35 scores did not differ. HT patients scored higher than AVR on specific questions regarding integration of the organ/device. AVR patients showed more affective disturbance and lower mental QoL than HT subjects. Affective scores correlated negatively with body image scores. Seventeen percent of all patients showed psychological distress (HADS scores >8). CONCLUSIONS HT patients integrated the new organ well - and even better than AVR subjects did with the device. In general, our data corroborate a good adaptation process, in particular in HT patients. Similar to other reported data, a subgroup of 15-20% of patients shows stronger mental distress, including body image problems. These must be identified and treated by professionals. Patients with AVR deserve more attention in the future.
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Affiliation(s)
- Armin Hartmann
- a Department of Psychosomatic Medicine and Psychotherapy , Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg , Freiburg , Germany
| | - Claudia Heilmann
- b Department of Cardiovascular Surgery, Heart Center , Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg , Freiburg , Germany
| | - Josefine Kaps
- a Department of Psychosomatic Medicine and Psychotherapy , Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg , Freiburg , Germany
| | - Friedhelm Beyersdorf
- b Department of Cardiovascular Surgery, Heart Center , Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg , Freiburg , Germany
| | - Wolfgang Zeh
- c Department of Cardiology and Angiology II , University Heart Centre Freiburg - Bad Krozingen , Bad Krozingen , Germany
| | | | - Michael Wirsching
- a Department of Psychosomatic Medicine and Psychotherapy , Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg , Freiburg , Germany
| | - Kurt Fritzsche
- a Department of Psychosomatic Medicine and Psychotherapy , Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg , Freiburg , Germany
| | - Andreas Joos
- a Department of Psychosomatic Medicine and Psychotherapy , Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg , Freiburg , Germany
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Varnado S, Peled-Potashnik Y, Huntsberry A, Lowes BD, Zolty R, Burdorf A, Lyden ER, Moulton MJ, Um JY, Raichlin E. Effect of diltiazem on exercise capacity after heart transplantation. Clin Transplant 2017; 31. [DOI: 10.1111/ctr.12997] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Sara Varnado
- Division of Cardiology; University of Nebraska Medical Center; Omaha NE USA
| | | | - Ashley Huntsberry
- Division of Cardiology; University of Nebraska Medical Center; Omaha NE USA
| | - Brian D. Lowes
- Division of Cardiology; University of Nebraska Medical Center; Omaha NE USA
| | - Ronald Zolty
- Division of Cardiology; University of Nebraska Medical Center; Omaha NE USA
| | - Adam Burdorf
- Division of Cardiology; University of Nebraska Medical Center; Omaha NE USA
| | - Elizabeth R. Lyden
- Department of Biostatistics; College of Public Health; University of Nebraska Medical Center; Omaha NE USA
| | - Michael J. Moulton
- Department of Cardiothoracic Surgery; University of Nebraska Medical Center; Omaha NE USA
| | - John Y. Um
- Department of Cardiothoracic Surgery; University of Nebraska Medical Center; Omaha NE USA
| | - Eugenia Raichlin
- Department of Cardiology; Loyola University Medical Center; Maywood IL USA
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Peled Y, Varnado S, Lowes BD, Zolty R, Lyden ER, Moulton MJ, Um JY, Raichlin E. Sinus tachycardia is associated with impaired exercise tolerance following heart transplantation. Clin Transplant 2017; 31. [DOI: 10.1111/ctr.12946] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2017] [Indexed: 12/14/2022]
Affiliation(s)
- Yael Peled
- Heart Center; Sheba Medical Center; Ramat Gan and Sackler School of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Sara Varnado
- Division of Cardiology; University of Nebraska Medical Center; Omaha NE USA
| | - Brian D. Lowes
- Division of Cardiology; University of Nebraska Medical Center; Omaha NE USA
| | - Ronald Zolty
- Division of Cardiology; University of Nebraska Medical Center; Omaha NE USA
| | - Elizabeth R. Lyden
- Department of Biostatistics; College of Public Health; University of Nebraska Medical Center; Omaha NE USA
| | - Michael J. Moulton
- Department of Cardiothoracic Surgery; University of Nebraska Medical Center; Omaha NE USA
| | - John Y. Um
- Department of Cardiothoracic Surgery; University of Nebraska Medical Center; Omaha NE USA
| | - Eugenia Raichlin
- Division of Cardiology; University of Nebraska Medical Center; Omaha NE USA
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Nytrøen K, Gullestad L. Exercise after heart transplantation: An overview. World J Transplant 2013; 3:78-90. [PMID: 24392312 PMCID: PMC3879527 DOI: 10.5500/wjt.v3.i4.78] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 07/15/2013] [Accepted: 07/25/2013] [Indexed: 02/05/2023] Open
Abstract
While life expectancy is greatly improved after a heart transplant, survival is still limited, and compared to the general population, the exercise capacity and health-related quality of life of heart transplant recipients are reduced. Increased exercise capacity is associated with a better prognosis. However, although several studies have documented positive effects of exercise after heart transplantation (HTx), little is known about the type, frequency and intensity of exercise that provides the greatest health benefits. Moreover, the long-term effects of exercise on co-morbidities and survival are also unclear. Exercise restrictions apply to patients with a denervated heart, and for decades, it was believed that the transplanted heart remained denervated. This has since been largely disproved, but despite the new knowledge, the exercise restrictions have largely remained, and up-to-date guidelines on exercise prescription after HTx do not exist. High-intensity, interval based aerobic exercise has repeatedly been documented to have superior positive effects and health benefits compared to moderate exercise. This applies to both healthy subjects as well as in several patient groups, such as patients with metabolic syndrome, coronary artery disease or heart failure. However, whether the effects of this type of exercise are also applicable to heart transplant populations has not yet been fully established. The purpose of this article is to give an overview of the current knowledge about the exercise capacity and effect of exercise among heart transplant recipients and to discuss future exercise strategies.
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Patients’ experiences of information and support during the first six months after heart or lung transplantation. Eur J Cardiovasc Nurs 2012. [DOI: 10.1177/1474515112466155] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Health behaviors contribute to quality of life in patients with advanced heart failure independent of psychological and medical patient characteristics. Qual Life Res 2012; 22:1603-11. [PMID: 23161327 DOI: 10.1007/s11136-012-0312-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2012] [Indexed: 12/20/2022]
Abstract
BACKGROUND Little is known about the contribution of health behaviors to quality of life (QoL) in heart transplant candidates. We examined physical activity, dietary habits, psychological, and medical patient characteristics as correlates of QoL among patients enrolled in the multisite Waiting for a New Heart Study. METHOD QoL (Minnesota Living with Heart Failure Questionnaire), demographic variables, psychological variables (e.g., depression, coping styles), and health behaviors (physical activity, dietary habits) were assessed in 318 patients (82% male, 53 ± 11 years) at the time of wait-listing and analyzed in 312 patients (excluding six underweight patients). Eurotransplant provided BMI and medical variables to compute the Heart Failure Survival Score (HFSS). Hierarchical multiple regression models were used to assess the independent contribution of health behaviors to QoL. RESULTS The HFSS was unrelated to QoL. As expected, psychological characteristics (depression, anxiety, vigilant coping style) contributed to impaired QoL, accounting for 22.9, 35.9, and 12.9% of the variance in total, emotional, and physical QoL, respectively. Physical inactivity further impaired QoL (total: 4.1%, p < 0.001; physical: 7.4%, p < 0.001). Dietary habits typically considered as unhealthy (i.e., infrequent consumption of fruits/vegetables/legumes; frequent intake of foods high in saturated fats) were related to enhanced physical QoL, but only among the overweight and obese patients. CONCLUSION Lifestyle interventions to modify negative emotions and to increase physical activity could help to improve QoL in heart transplant candidates, regardless of their disease severity. The role of eating habits in QoL among obese and overweight patients needs further exploration.
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Cardiac allograft hypertrophy is associated with impaired exercise tolerance after heart transplantation. J Heart Lung Transplant 2011; 30:1153-60. [PMID: 21621424 DOI: 10.1016/j.healun.2011.04.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Revised: 03/23/2011] [Accepted: 04/10/2011] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Exercise performance, an important aspect of quality of life, remains limited after heart transplantation (HTx). This study examines the effect of cardiac allograft remodeling on functional capacity after HTx. METHODS The total cohort of 117 HTx recipients, based on echocardiographic determination of left ventricle mass and relative wall thickness at 1 year after HTx, was divided into 3 groups: (1) NG, normal geometry; (2) CR, concentric remodeling; and (3) CH, concentric hypertrophy. Cardiopulmonary exercise testing was performed 5.03 ± 3.08 years after HTx in all patients. Patients with acute rejection or significant graft vasculopathy were excluded. RESULTS At 1 year post-HTx, 30% of patients had CH, 55% had CR and 15% had NG. Exercise tolerance, measured by maximum achieved metabolic equivalents (4.62 ± 1.44 vs 5.52 ± 0.96 kcal/kg/h), normalized peak Vo(2) (52 ± 14% vs 63 ± 12%) and Ve/Vco(2) (41 ± 17 vs 34 ± 6), was impaired in the CH group compared with the NG group. A peak Vo(2) ≤14 ml/kg/min was found in 6%, 22% and 48% of patients in the NG, CR and CH groups, respectively (p = 0.01). The CH pattern was associated with a 7.4-fold increase in relative risk for a peak Vo(2) ≤14 ml/kg/min compared with NG patients (95% confidence interval 1.1 to 51.9, p = 0.001). After multivariate analysis, a 1-year CH pattern was independently associated with a reduced normalized peak Vo(2) (p = 0.018) and an elevated Ve/Vco(2) (p = 0.035). CONCLUSIONS The presence of CH at 1 year after HTx is independently associated with decreased normalized peak Vo(2) and increased ventilatory response in stable heart transplant recipients. The identification of CH, a potentially reversible mechanism of impairment in exercise capacity after HTx, may have major clinical implications.
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Jokinen JJ, Hämmäinen P, Lemström KB, Lommi J, Sipponen J, Harjula ALJ. Association between gastrointestinal symptoms and health-related quality of life after heart transplantation. J Heart Lung Transplant 2010; 29:1388-94. [PMID: 20851638 DOI: 10.1016/j.healun.2010.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Revised: 06/03/2010] [Accepted: 07/02/2010] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Heart transplantation (HTx) ameliorates the self-perceived health-related quality of life (HRQoL) of patients with terminal heart disease; gastrointestinal (GI) symptoms, due to obligatory immunosuppression, may contribute to impaired HRQoL post-HTx. METHODS In this cross-sectional, exploratory study we aimed to investigate association between GI symptoms and HRQoL. The study consisted of 167 patients who had undergone HTx between 1985 and 2006 in Finland. Short-Form 36 (SF-36) Quality of Life and Gastrointestinal Symptom Rating Scale (GSRS) questionnaires were sent to the patients at the end of 2006 for capturing data on the HRQoL of HTx recipients. RESULTS Higher or equal SF-36 scores describing the HRQoL dimensions compared with the Finnish age- and gender-matched reference population were as follows: physical functioning, 60.5%; role-physical, 67.5%; bodily pain, 62.6%; general health, 64.0%; vitality, 68.1%; social functioning, 68.1%; role-emotional, 70.0%; and mental health, 70.4%. The prevalence of troublesome GI symptoms (GSRS score >1) per GSRS dimension was 53.9% for diarrhea, 91.0% for indigestion, 60.6% for constipation, 73.4% for abdominal pain, 46.4% for reflux and 95.8% for any GI symptom. Diabetes contributed to the presence of diarrhea (odds ratio [OR]: 3.00; 95% confidence interval [CI]: 1.12 to 8.00), use of prednisolone to indigestion (OR: 3.21; 95% CI: 1.05 to 9.79) and increased age to constipation (OR: 1.04; 95% CI: 1.02 to 1.07). CONCLUSIONS HRQoL after HTx is relatively good and comparable to the age- and gender-matched reference population. HRQoL is vulnerable to side-effects caused by the obligatory post-HTx immunosuppressive regimen, where GI symptoms play a major but clearly an underestimated role.
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Affiliation(s)
- Janne J Jokinen
- Department of Cardiothoracic Surgery, Helsinki University Hospital, Helsinki, Finland.
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Becker M, Erdmann N, Stegemann E, Benke D, Schauerte PN, Schaefer WM, Autschbach R, Kelm M, Koch KC. Survival and Quality of Life in Patients With Cardiac Resynchronization Therapy for Severe Heart Failure and in Heart Transplant Recipients Within a Contemporary Heart Failure Management Program. J Heart Lung Transplant 2008; 27:746-52. [DOI: 10.1016/j.healun.2008.03.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2007] [Revised: 01/05/2008] [Accepted: 03/27/2008] [Indexed: 11/16/2022] Open
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Pre-transplant Quality of Life Does Not Predict Survival After Lung Transplantation. J Heart Lung Transplant 2008; 27:623-7. [DOI: 10.1016/j.healun.2008.03.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2007] [Revised: 03/05/2008] [Accepted: 03/12/2008] [Indexed: 11/17/2022] Open
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Karapolat H, Eyigor S, Durmaz B, Yagdi T, Nalbantgil S, Karakula S. The relationship between depressive symptoms and anxiety and quality of life and functional capacity in heart transplant patients. Clin Res Cardiol 2007; 96:593-9. [PMID: 17593317 DOI: 10.1007/s00392-007-0536-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2006] [Accepted: 04/11/2007] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To establish the relationship between depressive symptoms and anxiety with both the quality of life and functional capacity of heart transplant patients. METHODS Thirty-four patients were included. Outcome measures were the Beck Depression Inventory (BDI), the State- Trait Anxiety Inventory (STAI), the Short Form 36 (SF36) and peak oxygen consumption (pVO2). RESULTS After the transplant there was a significant negative correlation between the BDI and most of subgroups on the SF36 (p<0.05). There were significant negative correlations found between the pVO2 and both the BDI and STAI-trait anxiety score (p<0.05). Statistically significant improvements were noted in all subgroups on the SF36 and all BDI scores after the transplant, in comparison to the pre-transplant period (p<0.05). CONCLUSIONS The functional capacity of a person affects the state of their depression and anxiety. We recommend participation in a cardiac rehabilitation program in the early stages of transplantation and believe that the quality of life, which has been shown to be related to the functional capacity and psychological symptoms, would benefit from this program.
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Affiliation(s)
- H Karapolat
- Ege University Medical Faculty, Physical Medicine and Rehabilitation Department, 35100, Bornova, Izmir, Turkey.
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Fusar-Poli P, Picchioni M, Martinelli V, Bhattacharyya S, Cortesi M, Barale F, Politi P. Anti-depressive Therapies After Heart Transplantation. J Heart Lung Transplant 2006; 25:785-93. [PMID: 16818121 DOI: 10.1016/j.healun.2006.03.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2005] [Revised: 02/07/2006] [Accepted: 03/27/2006] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Despite an improved quality of life, about 33% of heart transplant recipients will develop depressive symptoms post-operatively. To date, no review has explored the efficacy and safety of pharmacologic or psychologic interventions in this patient group. METHODS We conducted a comprehensive Medline, EmBase, Psycinfo search for studies of the treatment of depression in heart transplant recipients. RESULTS We identified 34 studies of variable methodologic quality. Selective serotonin re-uptake inhibitors (SSRIs), particularly citalopram and new-generation anti-depressants (mirtazapine), seem to represent the best therapeutic choices for this population. Tricyclic anti-depressants (TCAs), and electroconvulsive therapy (ECT) should be reserved for severe depression unresponsive to other treatments, whereas monoamine oxidase inhibitors (MAOIs) should be avoided. St John's wort, an alternative herbal drug, has been associated with life-threatening immunosuppression. Psychologic therapy offers further advantages after heart transplantation. CONCLUSIONS Further well-conducted, randomized, controlled trials are needed to clarify the efficacy and the safety of pharmacologic (SSRIs and atypical anti-depressants) and psychologic interventions in the management of depression after heart transplantation.
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Affiliation(s)
- Paolo Fusar-Poli
- Department of Applied and Psychobehavioural Sciences, University of Pavia, Pavia, Italy.
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Abstract
This review summarizes and integrates evidence concerning mental health outcomes following heart, lung, and heart-lung transplantation. Drawing on English-language case reports and empirical studies published between January 1980 and December 2004, the goals of the review were to (a) describe the prevalence and clinical characteristics of psychological disorders, as well as the level and pattern of clinically significant distress in the years posttransplant; (b) review the major risk factors for poor posttransplant psychological outcomes; (c) consider evidence suggesting that posttransplant psychological outcomes predict physical morbidity and mortality after transplant; (d) summarize findings from intervention studies designed to improve posttransplant psychological outcomes; and (e) provide patient care recommendations for the practicing clinician and recommendations for continued clinical research. Several major conclusions can be drawn from this literature. First, depressive and anxiety-related disorders and associated distress are common posttransplant. While new onsets of disorder may decline after the first year posttransplant, the development of new medical complications in the late years posttransplant may provoke renewed distress and recurrences of disorder. Second, risk factors for posttransplant psychological disorders and elevated distress include both standard risk factors observed in other populations (eg, younger age, lifetime history of psychiatric disorder) and transplant-specific factors related to physical functional impairments, social supports, and strategies for coping with health problems. Third, while little evidence has been published to date, there is some indication that posttransplant psychological outcomes can predict subsequent physical health outcomes. Fourth, extremely few intervention studies in cardiothoracic transplant recipients have been performed. The few reports indicate that multicomponent psychosocial strategies focused on risk factor reduction and enhancement of personal coping resources may lead to reductions in psychological distress. An important caveat in considering all of the evidence reviewed is that most studies focus on heart rather than lung or heart-lung recipients. Recommendations for practicing clinicians focus on assessment and treatment options, based on the evidence to date. Research recommendations focus on the need for intervention effectiveness studies.
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Affiliation(s)
- Mary Amanda Dew
- Department of Psychiatry, University of Pittsburgh School of Medicine and Medical Center, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
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Fusar-Poli P, Martinelli V, Klersy C, Campana C, Callegari A, Barale F, Viganò M, Politi P. Depression and quality of life in patients living 10 to 18 years beyond heart transplantation. J Heart Lung Transplant 2005; 24:2269-78. [PMID: 16364881 DOI: 10.1016/j.healun.2005.06.022] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2005] [Revised: 06/21/2005] [Accepted: 06/24/2005] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The purpose of this study was to advance current understanding of factors that influence long-term quality-of-life (QoL) outcomes after heart transplantation, by addressing the influence of depression on perceived health status. METHODS Data were collected from all recipients (n = 137) still alive at >10 years after transplantation. They completed the Short Form Health Survey (SF-36) inventory and the Beck Depression Inventory (BDI) questionnaire, while objective measures of health status were retrieved from medical records. All instruments used had acceptable reliability and validity. Data were analyzed using descriptive statistics, general linear regression models and survival analysis. RESULTS We assessed 137 patients who received transplants between November 1985 and June 1994 in Pavia and have survived 10 to 18 years after transplantation (mean 13.64 years, SD 2.25). They rated their health as good and only the physical QoL (PCS) was impaired when compared with the general population. Thirty-two percent of patients experienced mood depressive symptoms in the long term after transplantation, indicating a low perceived QoL. Higher educational qualification (p = 0.049), being unemployed and receiving a disability pension (p = 0.001), high triglycerides levels (p = 0.020) and lack of physical activity (p < 0.001) were predictors of high BDI scores. CONCLUSIONS Assessment of depression levels and better understanding of risk factors for psychiatric disorders in the long term after transplantation could be of benefit in predicting negative outcomes and allowing future developments in patient management.
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Affiliation(s)
- Paolo Fusar-Poli
- DSSAeP, Sezione di Psichiatria, Università di Pavia and Servizio Psichiatrico di Diagnosi e Cura San Matteo, Pavia, Italy.
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Politi P, Piccinelli M, Fusar-Poli P, Poli PF, Klersy C, Campana C, Goggi C, Viganò M, Barale F. Ten years of "extended" life: quality of life among heart transplantation survivors. Transplantation 2004; 78:257-63. [PMID: 15280687 DOI: 10.1097/01.tp.0000133537.87951.f2] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Long-term quality of life (QOL) outcome in heart transplant recipients still remains uncertain. This study evaluates the health status and QOL of survivors with associated predictors 10 years after heart transplantation. PATIENTS AND METHODS A total of 276 patients who underwent heart transplantation in the Department of Cardiac Surgery, University of Pavia, between 1985 and 1992 were included in a cross-sectional study. Patients still alive 10 years after transplantation (n=122) were asked to complete the SF36 questionnaire and then received a full clinical examination. All QOL instruments that were used had acceptable reliability and validity. Descriptive statistics, Kaplan-Meier estimate, correlation coefficients, and general linear regression were used to analyze the data. RESULTS Survival rates 1, 5, and 10 years after transplantation were 87%, 77%, and 57%, respectively, and the average life expectancy was 9.16 years. The mental QOL of patients 10 years after heart transplantation was similar to that among the general population. The physical QOL was worse among patients when compared with the QOL of the general population, with predictors including older age, being married, the presence of complications, and impaired renal function. CONCLUSIONS Heart transplantation ensures a relatively high QOL even 10 years after surgery. Predictors of a poor QOL were determined, which may help to identify those patients for whom a poor outcome is likely so treatment can be tailored accordingly.
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Affiliation(s)
- Pierluigi Politi
- DSSAeP, Sezione di Psichiatria, Università di Pavia and Servizio Psichiatrico di Diagnosi e Cura, IRCCS Policlinico San Matteo-Pavia, 27100 Pavia, Italy.
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