Quality of Life of Patients with Severe Aortic Stenosis: Symptoms Result in Severe Physical and Emotional Disability Impairing Normal Daily Life
Martijn W.A. van Geldorp, MD, Helena Heuvelman, MD, A. Pieter Kappetein, MD, PhD, Jan J.V. Busschbach, MD, PhD, Johanna J.M. Takkenberg, Ad J.J.C. Bogers, MD, PhD.
OBJECTIVE: The quality of life of patients with symptomatic severe aortic stenosis is not often explored while the incidence of the disease is increasing, and many elderly patients who have an indication for aortic valve replacement are denied surgery. We studied the quality of life in patients with severe aortic stenosis, hypothesizing that in symptomatic patients impairment may be more severe than expected, which possibly could enforce the indication for surgery.
METHODS: The SF-36v2 Health Survey was used to analyse the quality of life of 192 patients with symptomatic or asymptomatic severe aortic stenosis. Patients were stratified according to age in three different groups: below 60 years, 61-70 years or higher than 70 years.
RESULTS: Symptomatic patients (n=132) had significantly lower health scores than the general Dutch population in all age groups (please see Figure for results of age group >70). Physical functioning was much lower although bodily pain was comparable to the general population. General health and vitality were also impaired, as well as social functioning, emotional wellbeing and mental health.
CONCLUSIONS: This study shows that both physical and emotional problems have major impact on normal daily life and social functioning of symptomatic patients with severe aortic stenosis. In symptomatic patients, the decision to perform aortic valve replacement should not only be based on expected gain in life-expectancy, but also based on the severely impaired quality of life patients have with conservative treatment. Furthermore, using the SF-36v2 Health Survey together with this study, a patient’s quality of life profile can be assessed and compared with the patient group or with the general population. This can help decision making on treatment of the individual patient.
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