Abstract 12059: Emotional Distress and Perceived Sexual Difficulties in Patients With Stage C Heart Failure and Patients With Left Ventricular Assist Device
Background: It has not yet elucidated whether left ventricular assist device (LVAD) improves emotional distress and sexual activity. Sexual concern is a critical issue among patients with heart failure regardless of heart failure stage. The purpose of this study was to clarify quality of life (QOL) and perceived sexual difficulties in LVAD patients compared with patients with stage C heart failure.
Methods: Of 315 patients who were enrolled into this study, 56 patients (18%) received LVAD therapy. QOL was assessed with the Minnesota Living with Heart Failure Questionnaire (MLHFQ), which evaluates the perception of effects of HF and its treatment on patient’s life on a 6 point Likert scale. A higher score indicates a worse QOL. Sexual concern was evaluated by the item 12 of the MLHFQ. A score of ≥4 was defined as the presence of sexual difficulties. To clarify factors related to the sexual difficulties, logistic regression analyses were used.
Results: Compared with patients with stage C heart failure, LVAD patients were younger (64.5±13.5 vs. 41.1±11.3, p≤0.01). There were no significant differences in the total score and the physical score of the MLHFQ between LVAD patients and patients with stage C heart failure (37.4±21.1 vs. 35.1±22.8;15.5±9.6 vs. 15.6±10.6). On the other hand, emotional QOL in LVAD patients was significantly worse than that in those with stage C heart failure (10.2±5.7 vs. 8.2±6.1, p=0.03). Noteworthy, LVAD patients had more sexual difficulties (19% vs. 8.5%, p=0.02). Age adjusted multivariate analyses showed that higher plasma levels of B-type natriuretic peptide (BNP) and lower levels of serum albumin were independent predictors for the presence of sexual difficulties among LVAD patients, whereas only higher heart rate predicted sexual difficulty in patients with stage C heart failure (all, p≤0.05). Higher levels of BNP in stage C heart failure were likely to related to the perceived sexual difficulties in univariate analysis (p=0.08).
Conclusions: LVAD therapy seems to improve physical QOL equally to patients with stage C heart failure. On the other hand, LVAD patients still suffer from psychological distress and have sexual difficulties. Psychological supports and sexual counseling as well as further development of LVAD are necessary.
- © 2013 by American Heart Association, Inc.