Abstract 11672: Limited Improvement in Global Quality of Life Measures After TAVR

Abstract

Introduction: Transcatheter aortic valve replacement (TAVR) is now the preferred treatment for older adults with symptomatic aortic stenosis (AS). While the goal is often symptom improvement, quality of life (QOL) may be adversely impacted by non-cardiac conditions. We evaluated changes in the global QOL Patient-Reported Outcomes Measurement Information System (PROMIS) Physical survey after TAVR. Methods: Single-center prospective study of 204 patients undergoing TAVR from 10/2019 to 6/2021. Subjects completed The Kansas City Cardiomyopathy Questionnaire (KCCQ) and PROMIS Physical surveys pre-TAVR and 30 days post-TAVR, of whom 85 (42%) had complete data on disease-specific and global QOL. A clinically meaningful change in PROMIS was defined as > 5 points. Good disease specific QOL was defined as KCCQ > 75. The correlation between KCCQ and PROMIS was assessed. Results: The mean age was 78.9 years and 47% identified as female. The mean pre-TAVR PROMIS Physical and KCCQ scores were 42 (SD 9.4) and 62.6 (SD 22.4), respectively. 30-days post TAVR, the average change in KCCQ was +23.0 (SD 24.9), while the average change in PROMIS Physical score was +3.9 (SD 8.8). There was modest correlation between post-procedure disease-specific and global QOL scores ( Figure 1 , R 2 0.48, p <0.001). At 30 days post-procedure, 69 patients (81.2%) reported good disease-specific QOL, while 36 (42.4%) had a clinically meaningful improvement in global QOL. Of patients with improvement in KCCQ, 33 (47.8%) reported a meaningful improvement in global QOL. Conclusions: The majority of patients report good disease-specific QOL after TAVR; however, less than ½ of TAVR treated patients have a clinically meaningful increase in global QOL at 30 days. There is modest correlation between disease-specific (KCCQ) and global (PROMIS) QOL scores following TAVR. Improvement in QOL after TAVR may be limited by conditions unrelated to AS.