Differential Impacts of Implantable Ventricular Assist Device on Quality of Life and Depression in Patients with Heart Failure and Their Caregivers

Abstract

Purpose Ventricular assist device (VAD) is an established therapy for patients with stage D heart failure. We aimed to clarify impacts of VAD on quality of life (QOL) and depression in those patients and their caregivers. Methods and Materials A total of 43 patients who were listed for heart transplantation were enrolled (43.0±11.5 years, male 86%). Of them, 13 patients were treated with implantable LVAD, and others were received extracorporeal Nipro VAD. QOL of patients and their caregivers was assessed with the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and SF-8, respectively. A lower MLHFQ score and a higher SF-8 score indicates better QOL. Patients and their caregivers were classified as suffering from depression when they had Center for Epidemiologic Studies Depression scale score ≥16. These outcomes were assessed approximately 6 month after VAD therapy and compared among the following three groups: medical therapy, extracorporeal Nipro VAD, and implantable LVAD. Results The MLHFQ score and prevalence of depression in patients receiving the Nipro VAD (n=13) were similar to those in patients with medical therapy (n=17) (42.8±27.4 vs. 47.3±22.0; 50% vs. 47%). On the other hand, implantable LVAD appeared to decrease patient’s MLHFQ score (-13.5±12.4, p=0.045 by paired t-test), but did not significantly change prevalence of depression (31%, p=0.460). In contrast, prevalence of depression in patients’ caregivers was likely to increase after placement of implantable LVAD (n=23, 17% vs. 36%). Physical summary score calculated from the SF-8 in the caregivers whose patients were treated with implantable LVAD was also significantly lower than that in Japanese national norms (n=12, 27.2±10.4 vs. 48.6±7.2, p Conclusions We demonstrate that implantable LVAD could improve patient’s QOL, consistently with earlier studies. Our results also suggest the need for support to reduce caregiver’s burden associated with implantable LVAD.