Continuous Flow Left Ventricular Assist Device Improves Functional Capacity and Quality of Life of Advanced Heart Failure Patients

Joseph G. Rogers, Keith D. Aaronson, Andrew J. Boyle, Stuart D. Russell, Carmelo A. Milano, Francis D. Pagani, Brooks S. Edwards, Soon Park, Ranjit John, John V. Conte, David J. Farrar, Mark S. Slaughter

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447 Scopus citations

Abstract

Objectives: This study sought to assess the impact of continuous flow left ventricular assist devices (LVADs) on functional capacity and heart failure-related quality of life. Background: Newer continuous-flow LVAD are smaller and quieter than pulsatile-flow LVADs. Methods: Data from advanced heart failure patients enrolled in the HeartMate II LVAD (Thoratec Corporation, Pleasanton, California) bridge to transplantation (BTT) (n = 281) and destination therapy (DT) (n = 374) trials were analyzed. Functional status (New York Heart Association [NYHA] functional class, 6-min walk distance, patient activity scores), and quality of life (Minnesota Living With Heart Failure [MLWHF] and Kansas City Cardiomyopathy Questionnaires [KCCQ]) were collected before and after LVAD implantation. Results: Compared with baseline, LVAD patients demonstrated early and sustained improvements in functional status and quality of life. Most patients had NYHA functional class IV symptoms at baseline. Following implant, 82% (BTT) and 80% (DT) of patients at 6 months and 79% (DT) at 24 months improved to NYHA functional class I or II. Mean 6-min walk distance in DT patients was 204 m in patients able to ambulate at baseline, which improved to 350 and 360 m at 6 and 24 months. There were also significant and sustained improvements from baseline in both BTT and DT patients in median MLWHF scores (by 40 and 42 U in DT patients, or 52% and 55%, at 6 and 24 months, respectively), and KCCQ overall summary scores (by 39 and 41 U, or 170% and 178%). Conclusions: Use of a continuous flow LVAD in advanced heart failure patients results in clinically relevant improvements in functional capacity and heart failure-related quality of life.

Original languageEnglish (US)
Pages (from-to)1826-1834
Number of pages9
JournalJournal of the American College of Cardiology
Volume55
Issue number17
DOIs
StatePublished - Apr 27 2010

Bibliographical note

Funding Information:
Supported by Thoratec Corporation . Dr. Rogers reports receiving consulting and grant support from Thoratec . Dr. Aaronson has received a research grant from Thoratec , HeartWare , and Terumo , and is an unpaid consultant for Thoratec. Dr. Boyle receives consulting support from Thoratec . Dr. Russell is a consultant for and has received research support from Thoratec . Dr. Milano receives research and training grants from Thoratec , Abiomed , and St. Jude , and research grants from Edwards Life Sciences and Sorin . Dr. Pagani receives training and consulting support from Thoratec . Dr. John received a research grant from Thoratec . Dr. Conti is an investigator on the HM2 trial. Dr. Farrar is an employee of Thoratec with equity ownership in the company. Dr. Slaughter receives grant support from Thoratec and Heartware .

Copyright:
Copyright 2010 Elsevier B.V., All rights reserved.

Keywords

  • HeartMate II
  • continuous flow
  • functional status
  • quality of life
  • ventricular assist devices

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