Impact of left ventricular function on health-related quality of life in coronary artery disease patients

Margarita Staniūtė,Jolanta Vaškelytė,Eglė Rumbinaitė,Birutė Kaminskaitė,Sigita Samsanavičienė,Sigita Plungienė,Julija Brožaitienė,Robertas Bunevičius

doi:10.1016/j.medici.2015.07.005

Margarita Staniūtė, Jolanta Vaškelytė + Show 6 more

Open Access

https://doi.org/10.1016/j.medici.2015.07.005

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Journal: Medicina	Publication Date: Jan 1, 2015
Citations: 4	License type: cc-by

Affiliation: Lithuanian University of Health Sciences

Abstract

ObjectiveThe aim of the study was to investigate the relation between health-related quality of life (HRQoL) and left ventricular systolic and diastolic function parameters in stable coronary artery disease (CAD) patients with mild and moderate heart failure. Materials and methodsThis study included 758 CAD patients. Left ventricular ejection fraction (LVEF) and ratio of peak velocities of early (E) and late (A) diastolic mitral inflow, ratio E/A, deceleration time, isovolumic relaxation time were assessed. Patients completed the SF-36 questionnaire. ResultsThere were no strong and significant associations between echocardiographic measures and HRQoL in NYHA I-II class patients. In NYHA III class in univariate linear regression analyses significant associations were found between LVEF and physical functioning (β=0.230, P=0.009) and role limitations due to physical problems (β=0.230, P=0.009) and these associations remain significant after adjustment for age, gender, hypertension, angina pectoris class, nitrate, ACE inhibitors and diuretics use. E/A ratio was significantly associated only with mental health domain (β=0.188, P=0.048), and this association remains significant after all adjustments. ConclusionsIn stable CAD patients with NYHA I-II functional class HRQoL was not strongly associated with left ventricular function; in NYHA III functional class patients’ greater systolic function mainly was associated with better physical health and better diastolic function, with better mental health.

Highlights

Coronary artery disease (CAD) is a major cause of mortality and disability in developed countries and causes a negative impact on the physical, psychological, social, and occupational functioning of patients [1]
The most common echocardiographic abnormalities seen in patients with heart failure related to systolic function is reduced left ventricular ejection fraction (LVEF) and in cases with preserved LVEF related to diastolic dysfunction – abnormalities of the mitral inflow pattern
Our study revealed significant differences in the associations between Health-related quality of life (HRQoL) and left ventricular systolic and diastolic function parameters in patients with stable CAD in different New York Heart Association (NYHA) functional classes

Summary

Introduction

Coronary artery disease (CAD) is a major cause of mortality and disability in developed countries and causes a negative impact on the physical, psychological, social, and occupational functioning of patients [1]. Left ventricular systolic and diastolic dysfunctions are important clinical prognostic factors for outcomes in stable CAD and heart failure and related with poor prognosis [4,5]. HRQoL in stable and unstable CAD patients was shown to be associated with clinical CAD severity [8], social support [9] and psychological factors, including symptoms of mental distress such as depression or anxiety [10]. It has been shown that in patients with systolic and diastolic heart failure, the impairment of HRQoL was similar in both its mental and physical components [13]. Another study showed that impaired physical quality of life in patients with diastolic dysfunction associates more strongly with neurohumoral activation than with echocardiographic parameters [14]. Data regarding the association of left ventricular function with HRQoL remain mixed and warrants additional research

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Results

Conclusion