Comparison of Quality of Life Between Patients with Advanced Heart Failure and Heart Transplant Recipients

Abstract Introduction: Heart transplantation is the treatment indicated for patients with advanced and refractory heart failure (HF). The transplant is expected to increase survival and improve the level of health-related quality of life (HRQoL). The aim of this study was to compare the level of HRQoL, as well as social and clinical variables, between patients with advanced HF and heart transplant (HT) recipients. Methods: This is a cross-sectional study, conducted at a Brazilian university hospital, during outpatient consultations. The level of HRQoL was assessed using the World Health Organization Quality of Life-Bref questionnaire. Descriptive statistics were used to analyze the data, and the comparison of the level of HRQoL was performed using the Mann-Whitney U test. Results: Two hundred sixty-two patients participated in the study. Seventy-nine of them had advanced-stage HF and 183 were HT recipients. Compared to patients with advanced HF, HT recipients had a better level of HRQoL, were less frequently absent from work due to health problems, had higher income, used a higher number of medications, and there was a higher percentage of retirees among them (P-value < 0.001). Conclusion: In every comparison, HT recipients showed a better level of HRQoL than patients with advanced HF, along with less absence from work and higher income. These results suggest that heart transplantation can improve HRQoL and survival of patients with advanced HF.

引言：心脏移植（Heart Transplantation）是晚期难治性心力衰竭（Heart Failure, HF）患者的推荐治疗方案。该治疗手段有望延长患者生存期并提升其健康相关生活质量（Health-Related Quality of Life, HRQoL）。本研究旨在对比晚期心力衰竭患者与心脏移植（Heart Transplant, HT）受者的健康相关生活质量水平，以及社会与临床相关变量。
方法：本研究为横断面研究，于巴西某大学附属医院的门诊随访期间开展。采用世界卫生组织生活质量简版量表（World Health Organization Quality of Life-Bref）评估受试者的健康相关生活质量水平。采用描述性统计学方法分析数据，通过曼-惠特尼U检验（Mann-Whitney U test）比较两组的健康相关生活质量水平。
结果：本研究共纳入262例受试者，其中79例为晚期心力衰竭患者，183例为心脏移植受者。与晚期心力衰竭患者相比，心脏移植受者的健康相关生活质量水平更高，因健康问题缺勤的频率更低，收入更高，服用药物数量更多，且退休者占比更高（P < 0.001）。
结论：各项对比均显示，心脏移植受者的健康相关生活质量优于晚期心力衰竭患者，且缺勤更少、收入更高。本研究结果表明，心脏移植可改善晚期心力衰竭患者的健康相关生活质量与生存率。