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Psycho-Emotional Status and Health-Related Quality of Life in Patients following Cardiac Valve Surgery
Tali Bayer-Topilsky1, Maurice Enriquez-Sarano2.
1Myers-JDC-Brookdale, Jerusalem, Israel, 2Mayo Clinic, Rochester, MN, USA.

Severe MR is associated with low psycho-emotional status (PES). Yet, it is unknown whether this association is causal and whether surgical correction affects PES. The current study assessed whether a causal association exists between severe mitral regurgitation (
MR) and PES and whether suppression of MR by surgery improves PES and Health-Related Quality of Life (HR-QoL).
METHODS: 131 patients (mean age, 60, male, 77%) undergoing MR surgery, 62 with MR treated conservatively and 35 with normal echocardiogram, were prospectively assessed with comprehensive measures of MR, PES (anxiety, posttraumatic symptoms (PTS) and depression) and HR-QoL at baseline and at post-operative 6 months follow-up.
RESULTS: Baseline PES scores were poorer in surgical group compared to normal controls (anxiety, p=0.01; PTS, p=0.02). Improvement was noted only in the mitral-operated group (all p≤ 0.02), and the follow-up assessment showed similar scores among all groups (all p≥0.4). Improvement with operation was independent of heart failure symptoms at baseline and was different between groups adjusted for symptoms (all p<0.02 adjusted). Baseline HR-QoL of patients in the surgical group were also poorer compared to other groups (LASA, all p<0.005; SF-12 Physical, all p<0.001). These measures improved significantly after surgery (all p≤0.0002) and resembled those of the other groups at follow up (all p>0.06). Improvement in PES and HR-QoL were not related to the surgical approach (robotic vs. standard, all p≥0.2).
CONCLUSIONS: Association between severe MR and poor PES is causal. Mitral valve surgery normalizes PES and HR-QoL, and the improvement is an added benefit of MR correction.

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