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Health-Related Quality of Life and Symptom Status by Gender in Heart Valve Surgery Patients
Niv Ad, Sari D. Holmes, Deborah Lamont, Lisa M. Martin.
Inova Heart and Vascular Institute, Falls Church, VA, USA.

Health-related quality of life (HRQL) has become a frequently used outcome to assess functionality in various clinical and health policy settings. The purpose of this study was to compare male and female patients on HRQL and symptom status changes up to 2 years following heart valve surgery.
METHODS: Valve surgery patients since October 2009 have been followed prospectively. SF-12 measured HRQL and Minnesota Living with Heart Failure Questionnaire (MLHFQ) measured symptoms. Data were available for 132 patients with baseline, 6, 12, and 24-month follow-up completed (female=55, male=77). Repeated measures ANOVAs evaluated gender differences in HRQL and MLHFQ scores over time.
RESULTS: Mean age was 68.0±12.0, with no difference by gender (p=0.08). Significant MLHFQ score improvement over time was found regardless of gender (F=38.7, p<0.001; Figure A) with a plateau appearing to occur after 6 months post-surgery. Both genders had similar patterns of change over time (F=0.2, p=0.91), but females reported more symptoms across all follow-up (F=8.4, p=0.004). Physical HRQL scores also improved significantly over time regardless of gender (F=19.5, p<0.001; Figure B) with a plateau appearing to occur after 6 months. Female and male patients had similar patterns of change over time in HRQL (F=0.5, p=0.65), but females reported lower HRQL across all follow-up (F=18.1, p<0.001). In females, there appeared to be a trend toward baseline HRQL between 12 and 24 months, although not significant. Physical HRQL and MLHFQ scores were significantly correlated with one another at each time point (r=-0.61 to -0.70, p-values<0.001) and correlations were significant within each gender.
CONCLUSIONS: These results demonstrate that substantial improvements in HRQL and symptomatology occurred following valve surgery. As found in previous work, women reported lower HRQL and greater symptoms across all time points, but both men and women can expect to experience similar relative improvements in these measures after valve surgery. Our findings suggest that HRQL should continue to be monitored in valve surgery patients during at least the first 12 months of recovery.

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