A longitudinal comparison of health‐related quality of life in rural and urban recipients of left ventricular assist devices

Left ventricular assist devices (LVAD) are a common treatment for advanced heart failure (HF) to improve ventricular function, symptoms, and health‐related quality of life (HRQOL). Many LVAD recipients travel long distances from rural areas for LVAD implantation and follow‐up care. Individuals with HF in rural settings who have not undergone LVAD implantation have reported poor HRQOL. However, to date, no studies have compared HF‐specific or generic HRQOL in rural and urban LVAD recipients. The purpose of this study was to compare generic and HF‐specific HRQOL longitudinally from preimplantation to 1‐, 3‐, and 6‐ months postimplant in a cohort of rural and urban LVAD recipients (n = 95; rural n = 32 and urban n = 63). We measured generic HRQOL using the European Quality of Life Visual Analog Scale and HF‐specific HRQOL with the quality of life domain of the Kansas City Cardiomyopathy Questionnaire (KCCQ). Latent growth curve modeling identified two phases of change in generic and HF‐specific HRQOL: the initial response to LVAD between preimplantation and 1‐month postimplant and the subsequent change between 1‐ and 6‐months postimplant. Comparable improvements in generic HRQOL were noted in rural and urban LVAD recipients during both phases of change. Urban LVAD recipients had greater initial improvements in HF‐specific HRQOL (KCCQ) compared with rural recipients (13.0 ± 5.6, p = .02), but subsequent improvements were similar among rural and urban recipients. Ongoing assessment of generic and HF‐specific HRQOL is necessary during LVAD therapy.