Quality of life in older adults with aortic stenosis: a narrative review

Horrocks, Judith; Closs, José; Astin, Felicity

doi:10.1111/opn.12026

Cited by 11 publications

(11 citation statements)

References 45 publications

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“…Quality of life is an important consideration for patients with severe AS, who are often elderly and have multiple co-morbid conditions. [18][19][20][21] The KCCQ has been shown to be valid and relevant in patients with severe AS, [2][3][4] but it focuses specifically on symptoms of HF and does not take into account factors that are specific to AS and its treatment. The SF-12v2 evaluates general health-related QoL 11 and is not able to differentiate between the effects of AS and the effects of other conditions, which is important, given that patients with AS tend to have multiple co-morbidities.…”

Section: Discussionmentioning

confidence: 99%

“…Quality of life is an important consideration for patients with severe AS, who are often elderly and have multiple co‐morbid conditions 18–21 . The KCCQ has been shown to be valid and relevant in patients with severe AS, 2–4 but it focuses specifically on symptoms of HF and does not take into account factors that are specific to AS and its treatment.…”

Section: Discussionmentioning

confidence: 99%

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Aortic valve replacement: validation of the Toronto Aortic Stenosis Quality of Life Questionnaire

et al. 2020

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Aims There is no quality of life tool specifically developed for patients with severe aortic stenosis (AS) to assess how this chronic condition and its treatment affect patients. The Toronto Aortic Stenosis Quality of Life Questionnaire (TASQ) has been developed to overcome this gap. The results of the validation of the TASQ in patients undergoing treatment for severe AS are presented. Methods and results Prospective study at 10 centres in Europe and Canada, which enrolled 274 patients with severe symptomatic AS undergoing surgical or transcatheter aortic valve replacement. Mean TASQ score at baseline was 71.2 points and increased to 88.9 three months after aortic valve implantation (P < 0.001). Increases were seen for the emotional impact (32.0 to 39.0; P < 0.001), physical limitations (14.8 to 22.0; P < 0.001), and physical symptoms (8.5 vs. 11.0; P < 0.001) domains. Internal consistency was good/excellent for overall TASQ score (α = 0.891) and for the physical limitation, emotional impact, and social limitation domains (α = 0.815–0.950). Test–retest reliability was excellent or strong for the overall TASQ (intraclass correlation coefficient of 0.883) and for the physical symptoms, physical limitation, emotional impact, and social limitation domains (intraclass correlation coefficient of 0.791–0.895). Responsiveness was medium overall (Cohen's d = 0.637) and medium/large for physical symptoms, emotional impact, and physical limitations (0.661–0.812). Sensitivity to change was significant for physical symptoms, physical limitations (both P < 0.001), emotional impact (P = 0.003), and social limitations (P = 0.038). Conclusions The TASQ is a new, brief, self‐administered, and clinically relevant health‐specific tool to measure changes in quality of life in patients with AS undergoing an intervention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Aortic valve replacement: validation of the Toronto Aortic Stenosis Quality of Life Questionnaire

et al. 2020

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“… 11 SF-12 has been used to assess health status in patients with AS undergoing AVR or TAVI. 12 The SF-12 (standard V.1.0) questionnaire consists of 12 items. The first question asks the patient to rate his/her health as excellent, very good, good, fair or poor.…”

Section: Methodsmentioning

confidence: 99%

Self-reported health status, treatment decision and survival in asymptomatic and symptomatic patients with aortic stenosis in a Western Norway population undergoing conservative treatment: a cross-sectional study with 18 months follow-up

Oterhals

Haaverstad²,

Nordrehaug

et al. 2017

BMJ Open

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ObjectivesTo investigate symptoms and self-reported health of patients conservatively treated for aortic stenosis (AS) and to identify factors associated with treatment decision and patient outcomes.DesignA cross-sectional survey with an 18-month follow-up.SettingOne tertiary university hospital in Western Norway.ParticipantsIn all, 1436 patients were diagnosed with AS between 2000 and 2012, and those 245 still under conservative treatment in 2013 were included in this study.Primary and secondary outcome measuresPrimary outcome measures were symptoms and self-reported health status. Secondary outcomes were treatment decision and patient survival after 18 months.ResultsA total of 136 patients with mean (SD) age 79 (12) years, 52% men responded. Among conservatively treated patients 77% were symptomatic. The symptom most frequently experienced was dyspnoea. Symptomatic patients reported worse physical and mental health compared with asymptomatic patients (effect size 1.24 and 0.74, respectively). In addition, symptomatic patients reported significantly higher levels of anxiety and depression compared with asymptomatic patients. However, symptom status did not correlate with haemodynamic severity of AS. After 18 months, 117 (86%) were still alive, 20% had undergone surgical aortic valve replacement (AVR) and 7% transcatheter aortic valve implantation (TAVI). When adjusting for age, gender, symptomatic status, severity of AS and European system for cardiac operative risk evaluation (EuroSCORE), patients with severe AS had more than sixfold chance of being scheduled for AVR or TAVI compared with those with moderate AS (HR 6.3, 95% CI 1.9 to 21.2, p=0.003). Patients with EuroSCORE ≥11 had less chance for undergoing AVR or TAVI compared with those with EuroSCORE ≤5 (HR 0.06, 95% CI 0.01 to 0.46, p=0.007).ConclusionsSymptoms affected both physical and mental health in conservatively treated patients with AS. Many patients with symptomatic severe AS are not scheduled for surgery, despite the recommendations in current guidelines. The referral practice for AVR is a path for further investigation.

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“…Elderly aortic stenosis sufferers present significant symptom burden, which includes exertional breathlessness, dizziness, chest pains, and syncope [6,7]. According to the World Health Organisation definition of QoL, it is an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards, and concerns.…”

Section: Introductionmentioning

confidence: 99%

Improvement of quality of life following transcatheter aortic valve implantation in the elderly: a multi-centre study based on the Polish national TAVI registry

et al. 2017

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A b s t r a c tBackground: Transcatheter aortic valve implantation (TAVI) is an effective therapeutic method for elderly high-risk patients with symptomatic severe aortic stenosis, not eligible for surgical treatment. Aim:The aim of the study was to evaluate short-term changes in elderly people's quality of life following TAVI, based on the POL-TAVI registry. Methods:One hundred and eighty-four octogenarians' and nonagenarians' samples from the POL-TAVI database were included in the study. The quality of life status was assessed with EQ-5D-3L questionnaire at baseline and after one-month follow-up. Results:The mean of patients' age was 84 (80-93) years. Logistic EuroSCORE mean was 19.83% (3.48-83.94%), and transaortic mean gradient was 54.99 (19.0-149.0) mm Hg. At baseline, up to 24.50% of patients declared severe problems in performing usual activities. 13.60% felt extreme pain or discomfort; 9.80% were unable to wash and dress by themselves; 8.20% were extremely anxious or depressed; and 7.10% of the patients in the study were confined to bed. After 30 days the percentage of patients declaring severe problems in each dimension did not exceed 4.00%. The comparison between quality of life data at baseline and after one-month follow-up showed a significant improvement in each of five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression (p < 0.001). Patients' quality of life was increasing regardless of gender (female vs. male), the type of anaesthesia (general vs. local), and the type of procedure (TA vs. TF). Conclusions:Short-term quality of life in the elderly subjects was significantly improved after one-month follow-up following TAVI.

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Quality of life in older adults with aortic stenosis: a narrative review

Cited by 11 publications

References 45 publications

Aortic valve replacement: validation of the Toronto Aortic Stenosis Quality of Life Questionnaire

Aortic valve replacement: validation of the Toronto Aortic Stenosis Quality of Life Questionnaire

Self-reported health status, treatment decision and survival in asymptomatic and symptomatic patients with aortic stenosis in a Western Norway population undergoing conservative treatment: a cross-sectional study with 18 months follow-up

Improvement of quality of life following transcatheter aortic valve implantation in the elderly: a multi-centre study based on the Polish national TAVI registry

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