Effect of cardiac resynchronization therapy-defibrillator implantation on health status in patients with mild versus moderate symptoms of heart failure

Henneke Versteeg, Krista C van den Broek, Dominic A M J Theuns, Paula M C Mommersteeg, Marco Alings, Pepijn H van der Voort, Luc Jordaens, Susanne S. Pedersen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Indications for cardiac resynchronization therapy (CRT) have expanded to include patients with mild congestive heart failure (CHF) symptoms (New York Heart Association [NYHA] functional class II) because of a demonstrated morbidity reduction in this subset of patients. However, little is known about postimplantation changes in their self-reported health status compared to patients with more severe CHF. The aim of this study was to examine the influence of baseline NYHA functional class on health status changes in the first 12 months after implantation of a CRT with defibrillator (CRT-D). Patients with first-time CRT-D (n = 169, 75% men, mean age 62.1 ± 10.7 years) were recruited from 3 Dutch hospitals. All patients completed the SF-36 Health Survey at the time of implantation and at 12 months after implantation. Mildly (NYHA functional class II; n = 54) and moderately (NYHA functional class III; n = 115) symptomatic CHF patients showed improved health status in several SF-36 domains at 12 months after CRT-D. When adjusting for baseline health status, the groups did not differ with respect to their health status improvement over time, but after adjustment for demographic and clinical factors, the mildly symptomatic patients reported relatively more improvement in general health (B = 10.15, SE = 3.31, p = 0.003) and social functioning (B = 10.64, SE = 3.74, p = 0.005). In conclusion, NYHA functional class II patients reported equal, and in some domains even more, improvement in health status compared to NYHA functional class III patients at 12 months after CRT-D. Hence, CRT not only prevents clinical adverse events in patients with mild CHF symptoms but also improves health status.
OriginalsprogEngelsk
TidsskriftAmerican Journal of Cardiology
Vol/bind108
Udgave nummer8
Sider (fra-til)1155-1159
ISSN0002-9149
DOI
StatusUdgivet - 2011

Fingeraftryk

Cardiac Resynchronization Therapy
Health Surveys

Citer dette

Versteeg, Henneke ; van den Broek, Krista C ; Theuns, Dominic A M J ; Mommersteeg, Paula M C ; Alings, Marco ; van der Voort, Pepijn H ; Jordaens, Luc ; Pedersen, Susanne S. / Effect of cardiac resynchronization therapy-defibrillator implantation on health status in patients with mild versus moderate symptoms of heart failure. I: American Journal of Cardiology. 2011 ; Bind 108, Nr. 8. s. 1155-1159.
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title = "Effect of cardiac resynchronization therapy-defibrillator implantation on health status in patients with mild versus moderate symptoms of heart failure",
abstract = "Indications for cardiac resynchronization therapy (CRT) have expanded to include patients with mild congestive heart failure (CHF) symptoms (New York Heart Association [NYHA] functional class II) because of a demonstrated morbidity reduction in this subset of patients. However, little is known about postimplantation changes in their self-reported health status compared to patients with more severe CHF. The aim of this study was to examine the influence of baseline NYHA functional class on health status changes in the first 12 months after implantation of a CRT with defibrillator (CRT-D). Patients with first-time CRT-D (n = 169, 75{\%} men, mean age 62.1 ± 10.7 years) were recruited from 3 Dutch hospitals. All patients completed the SF-36 Health Survey at the time of implantation and at 12 months after implantation. Mildly (NYHA functional class II; n = 54) and moderately (NYHA functional class III; n = 115) symptomatic CHF patients showed improved health status in several SF-36 domains at 12 months after CRT-D. When adjusting for baseline health status, the groups did not differ with respect to their health status improvement over time, but after adjustment for demographic and clinical factors, the mildly symptomatic patients reported relatively more improvement in general health (B = 10.15, SE = 3.31, p = 0.003) and social functioning (B = 10.64, SE = 3.74, p = 0.005). In conclusion, NYHA functional class II patients reported equal, and in some domains even more, improvement in health status compared to NYHA functional class III patients at 12 months after CRT-D. Hence, CRT not only prevents clinical adverse events in patients with mild CHF symptoms but also improves health status.",
keywords = "Cardiac Resynchronization Therapy, Defibrillators, Implantable, Follow-Up Studies, Health Status, Heart Failure, Humans, Male, Prospective Studies, Questionnaires, Severity of Illness Index, Stroke Volume, Treatment Outcome",
author = "Henneke Versteeg and {van den Broek}, {Krista C} and Theuns, {Dominic A M J} and Mommersteeg, {Paula M C} and Marco Alings and {van der Voort}, {Pepijn H} and Luc Jordaens and Pedersen, {Susanne S.}",
note = "Copyright {\circledC} 2011 Elsevier Inc. All rights reserved.",
year = "2011",
doi = "10.1016/j.amjcard.2011.06.019",
language = "English",
volume = "108",
pages = "1155--1159",
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Effect of cardiac resynchronization therapy-defibrillator implantation on health status in patients with mild versus moderate symptoms of heart failure. / Versteeg, Henneke; van den Broek, Krista C; Theuns, Dominic A M J; Mommersteeg, Paula M C; Alings, Marco; van der Voort, Pepijn H; Jordaens, Luc; Pedersen, Susanne S.

I: American Journal of Cardiology, Bind 108, Nr. 8, 2011, s. 1155-1159.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Effect of cardiac resynchronization therapy-defibrillator implantation on health status in patients with mild versus moderate symptoms of heart failure

AU - Versteeg, Henneke

AU - van den Broek, Krista C

AU - Theuns, Dominic A M J

AU - Mommersteeg, Paula M C

AU - Alings, Marco

AU - van der Voort, Pepijn H

AU - Jordaens, Luc

AU - Pedersen, Susanne S.

N1 - Copyright © 2011 Elsevier Inc. All rights reserved.

PY - 2011

Y1 - 2011

N2 - Indications for cardiac resynchronization therapy (CRT) have expanded to include patients with mild congestive heart failure (CHF) symptoms (New York Heart Association [NYHA] functional class II) because of a demonstrated morbidity reduction in this subset of patients. However, little is known about postimplantation changes in their self-reported health status compared to patients with more severe CHF. The aim of this study was to examine the influence of baseline NYHA functional class on health status changes in the first 12 months after implantation of a CRT with defibrillator (CRT-D). Patients with first-time CRT-D (n = 169, 75% men, mean age 62.1 ± 10.7 years) were recruited from 3 Dutch hospitals. All patients completed the SF-36 Health Survey at the time of implantation and at 12 months after implantation. Mildly (NYHA functional class II; n = 54) and moderately (NYHA functional class III; n = 115) symptomatic CHF patients showed improved health status in several SF-36 domains at 12 months after CRT-D. When adjusting for baseline health status, the groups did not differ with respect to their health status improvement over time, but after adjustment for demographic and clinical factors, the mildly symptomatic patients reported relatively more improvement in general health (B = 10.15, SE = 3.31, p = 0.003) and social functioning (B = 10.64, SE = 3.74, p = 0.005). In conclusion, NYHA functional class II patients reported equal, and in some domains even more, improvement in health status compared to NYHA functional class III patients at 12 months after CRT-D. Hence, CRT not only prevents clinical adverse events in patients with mild CHF symptoms but also improves health status.

AB - Indications for cardiac resynchronization therapy (CRT) have expanded to include patients with mild congestive heart failure (CHF) symptoms (New York Heart Association [NYHA] functional class II) because of a demonstrated morbidity reduction in this subset of patients. However, little is known about postimplantation changes in their self-reported health status compared to patients with more severe CHF. The aim of this study was to examine the influence of baseline NYHA functional class on health status changes in the first 12 months after implantation of a CRT with defibrillator (CRT-D). Patients with first-time CRT-D (n = 169, 75% men, mean age 62.1 ± 10.7 years) were recruited from 3 Dutch hospitals. All patients completed the SF-36 Health Survey at the time of implantation and at 12 months after implantation. Mildly (NYHA functional class II; n = 54) and moderately (NYHA functional class III; n = 115) symptomatic CHF patients showed improved health status in several SF-36 domains at 12 months after CRT-D. When adjusting for baseline health status, the groups did not differ with respect to their health status improvement over time, but after adjustment for demographic and clinical factors, the mildly symptomatic patients reported relatively more improvement in general health (B = 10.15, SE = 3.31, p = 0.003) and social functioning (B = 10.64, SE = 3.74, p = 0.005). In conclusion, NYHA functional class II patients reported equal, and in some domains even more, improvement in health status compared to NYHA functional class III patients at 12 months after CRT-D. Hence, CRT not only prevents clinical adverse events in patients with mild CHF symptoms but also improves health status.

KW - Cardiac Resynchronization Therapy

KW - Defibrillators, Implantable

KW - Follow-Up Studies

KW - Health Status

KW - Heart Failure

KW - Humans

KW - Male

KW - Prospective Studies

KW - Questionnaires

KW - Severity of Illness Index

KW - Stroke Volume

KW - Treatment Outcome

U2 - 10.1016/j.amjcard.2011.06.019

DO - 10.1016/j.amjcard.2011.06.019

M3 - Journal article

VL - 108

SP - 1155

EP - 1159

JO - The American Journal of Cardiology

JF - The American Journal of Cardiology

SN - 0002-9149

IS - 8

ER -