Patient-reported Outcomes In Heart Failure: Insights From A Simplified Kccq In Heartmate 3 Lvad Recipients

Document Type

Conference Proceeding

Publication Date

1-1-2025

Publication Title

J Card Fail

Abstract

Background: Patient-reported outcomes, such as the Kansas City Cardiomyopathy Questionnaire (KCCQ), are pivotal in assessing the impact of left ventricular assist device (LVAD) support on patients’ heart failure-related quality of life (hf-QOL) as part of hierarchical outcomes. However, translating improvements in composite KCCQ scores into a meaningful message for patients and referring providers remains challenging. In registries, incompleteness of KCCQ scores is also common after 1 year, perhaps due to questionnaire length. Purpose: This study aims to a) evaluate the utility of a simplified KCCQ score in describing the LVAD patient journey and b) to generate a patient-friendly graphic on hf-QOL trajectory for use during shared decision making encounters. Methods: Question-level KCCQ responses were analyzed in HeartMate 3 LVAD recipients from the MOMENTUM 3 studies (2,200 patients) preoperatively and at 6- 12-, and 24-months after implant. Patients had to complete one preoperative and ≥1 postoperative KCCQ assessment for inclusion. The simplified LVAD-KCCQ is as follows: 23 KCCQ questions from 5 domains were simplified into 5 questions, 1 from each domain. Response options were consolidated into severely, moderately and minimal/none from 5-7 prior options. The trajectories of within patient changes in the simplified KCCQ domains were evaluated at each time point. Results: There were sustained improvements from baseline in the summary standard and simplified KCCQ scores and within each simplified domain, beginning 6 months postoperatively (table 1, figure 1). Intra-patient improvements occurred rapidly in each domain and were sustained to two years. Of those who were severely limited in their enjoyment of life (blue) prior to LVAD (n=1133), <17.8% (n=202) and <8.2% (n=93) had persistently severe limitations at 6 months and 1 year, respectively. Overall, 63% of patients has no/minimal limitations at 2 years (Fig 1A, Fig 2). Similar rapid and sustained improvements were noted for response to the other simplified KCCQ domains (Fig 1B-C). Conclusion: An assessment of individual simplified KCCQ domain responses allows for a succinct assessment of the patient journey after HM3. These data may assist in improving KCCQ data compliance with registries and in conveying average changes in hf-QOL after LVAD to patients.

Volume

31

Issue

1

First Page

200

Last Page

201

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