QUALITY OF LIFE AND EMOTIONAL STATE IN PATIENTS AFTER SURGICAL CORRECTION OF ACQUIRED MITRAL VALVE DISEASE DEPENDS ON THE PRESENCE OF PREOPERATIVE PULMONARY HYPERTENSION

Highlights

• One of the factors that significantly contribute to the severity of the disease in patients with acquired valvular heart disease is the presence not only intracardiac hemodynamic disorders, but also preoperative pulmonary hypertension.
• Patients with acquired mitral valve disease and preoperative pulmonary hypertension showed significant positive dynamics in the quality of life in many parameters within the first month after surgery. However, patients without pulmonary hypertension were more compensated at baseline and noted functional limitations in the postoperative period.
• Factors associated with deterioration in quality of life and emotional status before and after surgical correction of acquired mitral valve disease were identified as the presence of preoperative atrial fibrillation and male gender.

Summary

Aim. To analyze a perioperative quality of life and emotional state of patients with acquired mitral valve disease (AMVD) who underwent surgical correction, as well as to assess the contribution of preoperative pulmonary hypertension (PH) to the perioperative dynamics of these parameters.

Methods. The study included 103 patients with AMVD of noninfectious origin, who were hospitalized for elective cardiac surgery. 61.2% of patients had PH before surgery. Quality of life (SF-36) and emotional state (HADS) analysis were conducted before surgery and on day 7, one month and one year after surgery.

Results. Patients with AMVD and preoperative PH showed significant positive dynamics in the quality of life in many parameters within the first month after surgery. However, patients without PH were more compensated at baseline and noted functional limitations in the postoperative period. It was found that an increase in the age of a patient with AMVD by 1 year is associated with a decrease in the initial level of the physical component of health by B-coefficient = –0.21 (p = 0.014). The presence of atrial fibrillation before the correction of the AMVD was associated with a decrease in the physical component of health on day 7 (B-coefficient = –10.92; p = 0.03) and decrease in the mental component of health on day 30 after surgery (B-coefficient = –12.66; p = 0.006). Male gender is associated with increased levels of anxiety and depression at all control points with lower level of mental health than women with AMVD.

Conclusion. Factors associated with a deterioration in quality of life and emotional status both before and after surgical correction of acquired mitral valve disease were identified as the presence of preoperative atrial fibrillation and male gender.

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