Tohoku J. Exp. Med., 2022 May, 257(1)

Changes in the Quality of Life of Patients with Left Ventricular Assist Device and their Caregivers in Japan: Retrospective Observational Study

Fumika Suzuki,¹ Hiroe Sato,² Masatoshi Akiyama,³ Miki Akiba,⁴ Osamu Adachi,¹ Taku Harada,¹ Yoshikatsu Saiki⁵ and Masahiro Kohzuki¹

¹Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
²Health Administration Center, Niigata University, Niigata, Niigata, Japan
³Department of Cardiovascular Surgery, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
⁴Division of Organ Transplantation, Tohoku University Hospital, Sendai, Miyagi, Japan
⁵Department of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan

Left ventricular assist devices (LVAD) improve quality of life (QOL) in many patients with end-stage severe heart failure, but not in some patients. In addition, the burden on caregivers is expected to increase after LVAD patients are discharged. Our study aimed to investigate the impact of LVAD on the QOL of patients and caregivers. Thirty-two LVAD patients were assessed for changes in QOL, mental status, and activity level using the Euro QOL (EQ-5D-5L), Short Form 12 (SF-12), Minnesota Living with Heart Failure Questionnaire, Hospital Anxiety and Depression Scale (HADS), and Frenchay Activities Index. Twenty-four caregivers were assessed for changes in QOL, mental status, and burden of care using the EQ-5D-5L, SF-12, HADS, and Burden Index of Caregiver (BIC-11). The LVAD patients and caregivers responded contemporaneously regarding two points: pre-and post-LVAD. Patients’ physical and mental QOL was significantly improved, but not social QOL and activity level. Caregivers’ QOL and burden of care did not change, and anxiety was reduced (p = 0.028). The patients were divided into two groups based on whether EQ-5D-5L was improved: twelve patients in the unimproved group (UG) and twenty patients in the improved group (IG). In the UG, 50% had LVAD-related strokes (p = 0.001, IG: 0%), and their social QOL decreased (p = 0.023). The activity levels improved in the IG. Multi-dimensional analyses on the QOL in LVAD patients yielded mixed results. Anticipated benefits derived from LVAD therapy may be limited by LVAD-related complications such as stroke that negatively impacts on the QOL.

Keywords —— caregivers; heart failure; left ventricular assist device; quality of life; stroke

© 2022 Tohoku University Medical Press

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Tohoku J. Exp. Med 2022, 257, 44-55.

Correspondence: Masahiro Kohzuki, M.D., Ph.D., Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.

e-mail: kohzuki@med.tohoku.ac.jp