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Preoperative left-ventricular ejection fraction does not influence the improvement in quality of life after coronary
H Sjöland1, K Caidahl, I Wiklund
1Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
Insights
Coronary artery bypass grafting (CABG) improves quality of life (QoL) for angina patients. This improvement is not dependent on pre-operative left-ventricular ejection fraction (LVEF).
Area of Science:
- Cardiology
- Cardiac Surgery
- Quality of Life Research
Background:
- Coronary artery bypass grafting (CABG) is a standard treatment for angina pectoris, offering pain relief and enhanced physical function.
- While CABG improves survival in specific patient groups with advanced coronary artery disease and reduced left-ventricular ejection fraction (LVEF), its impact on quality of life (QoL) in these subgroups requires further investigation.
Purpose of the Study:
- To investigate whether the quality of life (QoL) outcomes following coronary artery bypass grafting (CABG) are more favorable in patients with depressed left-ventricular ejection fraction (LVEF).
Main Methods:
- A cohort of 2121 patients undergoing CABG without concomitant valve surgery in western Sweden (1988-1991) were assessed.
- Quality of life (QoL) was measured using the Physical Activity Score, Nottingham Health Profile, and Psychological General Well-being Index, preoperatively and at three intervals within two years post-surgery.
Main Results:
- Overall QoL improved significantly across all measurement instruments in the two years following CABG.
- The degree of QoL improvement was not associated with preoperative left-ventricular ejection fraction (LVEF).
- Postoperative self-estimated physical abilities showed an association with preoperative LVEF, but health-related QoL and general well-being did not.
Conclusions:
- The enhancement in quality of life (QoL) observed two years after coronary artery bypass grafting (CABG) is independent of the patient's preoperative left-ventricular ejection fraction (LVEF).
- While physical abilities post-CABG correlate with preoperative LVEF, broader measures of QoL and well-being are not influenced by this factor.
Abstract:
Coronary artery bypass grafting (CABG) is an established treatment for angina pectoris which conveys relief of chest pain and improved physical performance. However, increased survival has only been observed in selected subgroups of patients with advanced coronary artery disease, particularly in the presence of depressed left-ventricular ejection fraction (LVEF). It is therefore of interest to study whether the outcome in terms of quality of life (QoL) is also more favorable in candidates with depressed LVEF. All patients who underwent CABG without concomitant valve surgery in western Sweden between 6.1988 and 6.1991 (n = 2121) were sent questionnaires on QoL involving 3 different instruments, the Physical Activity Score, the Nottingham Health Profile, and the Psychological General Well-being Index. They were submitted before surgery and 3 times in the 2 years thereafter. QoL was improved on all postoperative occasions. The degree of improvement was not associated with preoperative LVEF for any of the instruments. The postoperative Physical Activity Score was associated with preoperative LVEF. The other instruments showed no such association with LVEF. The improvement in QoL during 2 years after CABG is not dependent on the LVEF determined prior to operation. Self-estimated physical abilities are postoperatively associated with preoperative LVEF whereas health-related QoL and general well-being are not.