Abstract
BackgroundHealth-related quality of life (HRQL) in hypertrophic cardiomyopathy (HCM) patients with implantable cardioverter-defibrillators (ICDs) is largely unknown. The aim was to assess HRQL, including comparisons between groups, using the questionnaire SF-36, and compare it to a Swedish age- and sex-matched population.Methods and ResultsValidated data on adult HCM patients with ICDs were used. The SF-36 response rate was 82.5 % and 245 patients (mean age 55.9 years, 70.2 % men) were analyzed using the Mann-Whitney U-test, t-test, Spearman correlation and effect size calculations. In all SF-36 domains the patients’ score was lower (p-value of <0.0001) than norms except for bodily pain. The general health domain showed the highest effect size (0.77) and the impact was more pronounced in the SF-36 physical component summary score (0.62) than the mental component summary score (0.46). Older age was correlated with lower scores on the physical component and higher scores on the mental component. Atrial fibrillation and/or systolic heart failure were associated with worse physical health. HRQL was similar in primary vs secondary prevention cases. Inappropriate ICD shock was associated with worse mental health while appropriate therapy trended toward better mental health.ConclusionHCM patients with ICDs suffer from poor HRQL regardless of age, sex, or primary vs secondary prevention indication. Atrial fibrillation and systolic heart failure are determinants of poor physical health. Inappropriate shocks, but not appropriate therapies, are associated with poorer mental health.
Highlights
Health-related quality of life (HRQL) in hypertrophic cardiomyopathy (HCM) patients with implantable cardioverter-defibrillators (ICDs) is largely unknown
We previously reported a longitudinal follow-up of ICDrelated complications requiring surgery and those experiencing inappropriate shocks
Cohort characteristics A total of 245 ICD patients with a validated diagnosis of HCM reported their HRQL according to social functioning (SF)-36 as depicted in the flow-chart (Fig. 1)
Summary
Health-related quality of life (HRQL) in hypertrophic cardiomyopathy (HCM) patients with implantable cardioverter-defibrillators (ICDs) is largely unknown. Hypertrophic cardiomyopathy (HCM) in adults is characterized by an abnormal thickening of the left ventricular wall (≥15 mm) that is not explained by other causes, such as hypertension or aortic stenosis [1]. Dyspnea may be aggravated by a left-ventricular outflow obstruction, tachycardia, or systolic heart failure (HF). Survivors of an episode of ventricular fibrillation or ventricular tachycardia with hemodynamic compromise are recommended an ICD for secondary prevention of SCD. Primary prevention candidates are selected based on evaluation of established risk factors: unexplained syncope, non-sustained ventricular tachycardia, abnormal exercise response, extreme myocardial thickness (≥30 mm), or a family history of SCD [4, 5].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
