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Predictors of health-related quality of life decline after transcatheter aortic valve replacement in older patients with severe aortic stenosis

  • Published:
The journal of nutrition, health & aging

Abstract

Background

Transcatheter aortic-valve implantation (TAVI) has been shown to improve survival and quality of life in patients with severe aortic stenosis. However, one-third of patients have poor outcome as death, functional decline or quality of life (QoL) decline. The aim of this study was to determine cardiac and geriatric predictors of physical and mental QoL decline 6 months after a TAVI procedure in patients aged 75 and older.

Methods

Between January 2013 and June 2014, we did a prospective and multicenter study including patients ≥ 75 years old referred for TAVI. The primary outcome was the measure of QoL, assessed by the Short Form 36 survey (SF-36), before and 6 months after the intervention. Association between QoL decline and baseline characteristics including cardiac and geriatric factors was analysed by logistic regression models.

Results

Mean age of the 150 patients studied was 83.7 years old and 56% were men. The primary end point, mean SF-36 physical summary score, significantly improved between baseline and 6-month (33.6 vs. 36.4, p=0.003) whereas mental component score significantly decreased (48.2 vs. 36.4, p-value<0.001). However, patients with presence of depressive symptoms before the intervention had mental QoL improvement at six months (OR 0.04 [0.01-0.19], p-value<0.001) and no significant geriatric predictors were associated with physical QoL decline.

Conclusion

The mental QoL significantly decreased and patients with preoperative depressive symptoms had mental QoL improvement at six months. Researches are needed to confirm that mental QoL of patients with depressive symptoms can be improved by TAVI.

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Authors and Affiliations

  1. Department of Geriatrics, EA 1156-12, Nantes University Hospital, Nantes, France

    Anne Sophie Boureau, A. Rouaud, G. Berrut & L. de Decker

  2. Inserm, UMR 1087, Department of Cardiology and Vascular diseases, Institut du Thorax, Nantes University Hospital, Nantes, France

    J. N. Trochu, P. Jaafar, T. Manigold, V. Letocart & P. Guerin

  3. Department of Geriatrics, Angers University Hospital, Angers, France

    R. Hureau

  4. Department of Geriatrics, Nantes University Hospital, boulevard Jacques Monod, 44093, Nantes Cedex 1, France

    Anne Sophie Boureau

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  1. Anne Sophie Boureau
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Correspondence to Anne Sophie Boureau.

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Boureau, A.S., Trochu, J.N., Rouaud, A. et al. Predictors of health-related quality of life decline after transcatheter aortic valve replacement in older patients with severe aortic stenosis. J Nutr Health Aging 21, 105–111 (2017). https://doi.org/10.1007/s12603-016-0739-5

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  • DOI: https://doi.org/10.1007/s12603-016-0739-5

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