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Quality of life among patients with severe aortic stenosis

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Abstract

Background

The disease burden of patients with severe aortic stenosis is not often explored, while the incidence is increasing and many patients who have an indication for aortic valve replacement are not referred for surgery. We studied the quality of life of 191 patients with severe aortic stenosis, hypothesising that symptomatic patients have a far worse quality of life than the general population, which could enforce the indication for surgery.

Methods

The SF-36v2 Health Survey was completed by 191 consecutive patients with symptomatic or asymptomatic severe aortic stenosis.

Results

Asymptomatic patients (n = 59) had health scores comparable with the general Dutch population but symptomatic patients (n = 132) scored significantly lower across different age categories. Physical functioning, general health and vitality were impaired, as well as social functioning and emotional well-being. There was no relation between degree of stenosis and physical or mental health scores.

Conclusions

Both physical and emotional problems have a major impact on normal daily life and social functioning of symptomatic patients with severe aortic stenosis, regardless of age. If the aortic stenosis is above the ‘severe’ threshold, the degree of stenosis does not predict disease burden. These results encourage to reconsider a conservative approach in symptomatic patients with severe aortic stenosis. Using the SF-36v2 Health Survey together with this study, an individual patient’s quality of life profile can be assessed and compared with the patient group or with the general population. This can assist in decision making for the individual patient.

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Acknowledgments

The authors would like to thank the patients, cardiologists, echo laboratory staff and secretaries of the following hospitals for their kind cooperation: Havenziekenhuis, Rotterdam; St. Franciscus Gasthuis, Rotterdam; IJsselland Hospital, Capelle aan den IJssel; Vlietland Hospital, Vlaardingen; Albert Schweitzer Hospital, Dordrecht; Medisch Centrum Rijnmond Zuid, Rotterdam; and Erasmus University Medical Center, Rotterdam.

Disclosures

None of the authors have any competing interests.

Author information

Authors and Affiliations

  1. Department of Cardio-thoracic Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands

    M. W. A. van Geldorp, H. J. Heuvelman, A. P. Kappetein, J. J. M. Takkenberg & A. J. J. C. Bogers

  2. Department of Medical Psychology and Psychotherapy, Erasmus University Medical Center, Rotterdam, the Netherlands

    J. J. V. Busschbach

  3. Saint Luke’s Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO, USA

    D. J. Cohen

  4. Department of Cardiothoracic Surgery, Catharina Hospital, PO Box 1350, 5602, ZA, Eindhoven, the Netherlands

    M. W. A. van Geldorp

Authors
  1. M. W. A. van Geldorp
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  2. H. J. Heuvelman
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  3. A. P. Kappetein
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  4. J. J. V. Busschbach
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  5. D. J. Cohen
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  6. J. J. M. Takkenberg
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  7. A. J. J. C. Bogers
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Corresponding author

Correspondence to M. W. A. van Geldorp.

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van Geldorp, M.W.A., Heuvelman, H.J., Kappetein, A.P. et al. Quality of life among patients with severe aortic stenosis. Neth Heart J 21, 21–27 (2013). https://doi.org/10.1007/s12471-012-0364-9

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