Patterns and predictors of dyspnoea following left ventricular assist device implantation

Kenneth M. Faulkner, Corrine Y. Jurgens, Quin E. Denfeld, Christopher Chien, Jessica Harman Thompson, Jill Gelow, Kathleen L. Grady, Christopher Lee

Research output: Contribution to journalArticlepeer-review

Abstract

AIMS: Dyspnoea is a common symptom of heart failure (HF) that often prompts patients to seek treatment. Implantation of a left ventricular assist device (LVAD) has been associated with reduced dyspnoea but it is unclear if all patients experience similar improvements in dyspnoea over time following LVAD implantation. Our aim was to identify distinct trajectories of dyspnoea symptoms over time following LVAD implantation and predictors of dyspnoea trajectory. We hypothesized that at least two, distinct trajectories of dyspnoea would be observed following LVAD implantation. METHODS AND RESULTS: This was a secondary analysis of data from the Profiling Biobehavioral Responses to Mechanical Support in Advanced Heart Failure study. In the parent study, sociodemographic and clinical data were collected prior to LVAD implantation and at 1, 3, and 6 months following LVAD implantation from a sample (n = 101) of patients with advanced HF. Latent growth mixture modelling was performed to identify distinct trajectories of dyspnoea symptoms. Backwards stepwise logistic regression was used to identify predictors of dyspnoea trajectory. Two, distinct trajectories of dyspnoea symptoms were identified: sustained improvement and unsustained improvement. Participants who experienced sustained improvement (86.7% of sample) demonstrated large, significant improvement in dyspnoea from pre-implantation to 3 months post-implant followed by smaller, non-significant improvement from 3 to 6 months. Participants who experienced unsustained improvement (13.3% of sample) demonstrated initial improvement from pre-implantation to 3 months post-implantation followed by worsening of dyspnoea from 3 to 6 months. Greater depressive symptoms at baseline and living alone were significant predictors of unsustained improvement. CONCLUSION: Patients experience different patterns of dyspnoea over time following LVAD implantation. Clinicians should inquire about living arrangements and depressive symptoms at each visit to determine risk of unsustained improvement in dyspnoea.

Original languageEnglish (US)
Pages (from-to)724-731
Number of pages8
JournalEuropean Journal of Cardiovascular Nursing
Volume21
Issue number7
DOIs
StatePublished - Oct 14 2022

Keywords

  • Dyspnoea
  • Growth mixture modelling
  • Heart failure
  • Ventricular assist device

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medical–Surgical
  • Advanced and Specialized Nursing

Fingerprint

Dive into the research topics of 'Patterns and predictors of dyspnoea following left ventricular assist device implantation'. Together they form a unique fingerprint.

Cite this