Health Related Quality of Life (HRQoL) after transcatheter aortic valve implantation in aortic stenosis patients: exploring a novel threshold for clinically significant improvement after 12 months

Abstract Aim The study aimed to determine the proportion of patients with significant improvements in Health-Related Quality of Life (HRQoL) 12 months after Transcatheter Aortic Valve Implantation (TAVI), using a threshold for physical function (PF) and physical role (RP) domains of the SF-36 questi...

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Main Authors: Marte Sævik, Marit Helen Andersen, Jan Otto Beitnes, Lars Aaberge, Per Steinar Halvorsen
Format: Article
Language:English
Published: SpringerOpen 2025-05-01
Series:Journal of Patient-Reported Outcomes
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Online Access:https://doi.org/10.1186/s41687-025-00894-1
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author Marte Sævik
Marit Helen Andersen
Jan Otto Beitnes
Lars Aaberge
Per Steinar Halvorsen
author_facet Marte Sævik
Marit Helen Andersen
Jan Otto Beitnes
Lars Aaberge
Per Steinar Halvorsen
author_sort Marte Sævik
collection DOAJ
description Abstract Aim The study aimed to determine the proportion of patients with significant improvements in Health-Related Quality of Life (HRQoL) 12 months after Transcatheter Aortic Valve Implantation (TAVI), using a threshold for physical function (PF) and physical role (RP) domains of the SF-36 questionnaire. Additionally, we explored shared baseline characteristics of patients reporting these improvements. Methodology In this prospective observational study, 88 patients with symptomatic, severe aortic stenosis (AS) and preserved ejection fraction were enrolled between April 2017 and February 2020. Exclusion criteria were clinical instability, pacemaker, chronic AF, comorbidities with life expectancy < 1 year. HRQoL was evaluated before and 12 months after transfemoral TAVI using the Norwegian version 2.0 of SF-36, and presented as mean (95% confidence interval). Other outcome measures were 6-minute walking test and NYHA- classification. Independent samples t-test or Mann-Whitney U test was used for between-group comparisons as appropriate. Logistic regression or Chi2-test were used to explore associations between changes in PF and RP and clinical parameters. Statistical significance was set at p ≤ 0.05, and clinically significant changes in HRQoL were defined as increase of ≥ 15 points in the PF and RP categories. Results Mean age of the cohort was 80 ± 6 years. 44 (50%) patients reported clinically significant improvement in PF, and 46 (52%) in the RP domain. Baseline scores were significantly lower in patients reporting clinical improvement after TAVI, with PF scores pre intervention 43.07 (37.37–48.78) vs. 65.34 (59.01–71.68), p < 0.001, and RP 36.01 (29.56–42.46) vs. 59.92 (50.91–68.92), p < 0.001. No significant associations were found between improvement in domain scores and parameters from the routine baseline examination, but having ≥ 15-point improvement correlated to baseline PF and RP scores. Conclusion Our study highlights the importance of defining a uniform threshold for clinically significant improvement in the SF-36 HRQoL questionnaire for patients undergoing TAVI. Half of the patients reported favorable long-term outcome for PF and RP aspects of SF-36. This emphasizes the importance of HRQoL assessment in the preoperative work up for patients undergoing TAVI. Trial registration https://www.clinicaltrials.gov/ 05.04.2017 with ID NCT03107923.
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spelling doaj-art-b933997fe2d545eb8fecd511dd81db122025-08-20T03:16:55ZengSpringerOpenJournal of Patient-Reported Outcomes2509-80202025-05-019111010.1186/s41687-025-00894-1Health Related Quality of Life (HRQoL) after transcatheter aortic valve implantation in aortic stenosis patients: exploring a novel threshold for clinically significant improvement after 12 monthsMarte Sævik0Marit Helen Andersen1Jan Otto Beitnes2Lars Aaberge3Per Steinar Halvorsen4The Intervention Centre, Rikshospitalet, Oslo University HospitalDepartment for Interdisciplinary Health Sciences, University of OsloDepartment of Cardiology, Oslo University HospitalDepartment of Cardiology, Oslo University HospitalThe Intervention Centre, Rikshospitalet, Oslo University HospitalAbstract Aim The study aimed to determine the proportion of patients with significant improvements in Health-Related Quality of Life (HRQoL) 12 months after Transcatheter Aortic Valve Implantation (TAVI), using a threshold for physical function (PF) and physical role (RP) domains of the SF-36 questionnaire. Additionally, we explored shared baseline characteristics of patients reporting these improvements. Methodology In this prospective observational study, 88 patients with symptomatic, severe aortic stenosis (AS) and preserved ejection fraction were enrolled between April 2017 and February 2020. Exclusion criteria were clinical instability, pacemaker, chronic AF, comorbidities with life expectancy < 1 year. HRQoL was evaluated before and 12 months after transfemoral TAVI using the Norwegian version 2.0 of SF-36, and presented as mean (95% confidence interval). Other outcome measures were 6-minute walking test and NYHA- classification. Independent samples t-test or Mann-Whitney U test was used for between-group comparisons as appropriate. Logistic regression or Chi2-test were used to explore associations between changes in PF and RP and clinical parameters. Statistical significance was set at p ≤ 0.05, and clinically significant changes in HRQoL were defined as increase of ≥ 15 points in the PF and RP categories. Results Mean age of the cohort was 80 ± 6 years. 44 (50%) patients reported clinically significant improvement in PF, and 46 (52%) in the RP domain. Baseline scores were significantly lower in patients reporting clinical improvement after TAVI, with PF scores pre intervention 43.07 (37.37–48.78) vs. 65.34 (59.01–71.68), p < 0.001, and RP 36.01 (29.56–42.46) vs. 59.92 (50.91–68.92), p < 0.001. No significant associations were found between improvement in domain scores and parameters from the routine baseline examination, but having ≥ 15-point improvement correlated to baseline PF and RP scores. Conclusion Our study highlights the importance of defining a uniform threshold for clinically significant improvement in the SF-36 HRQoL questionnaire for patients undergoing TAVI. Half of the patients reported favorable long-term outcome for PF and RP aspects of SF-36. This emphasizes the importance of HRQoL assessment in the preoperative work up for patients undergoing TAVI. Trial registration https://www.clinicaltrials.gov/ 05.04.2017 with ID NCT03107923.https://doi.org/10.1186/s41687-025-00894-1Aortic stenosis (AS)Transcatheter aortic valve implantation (TAVI)Health related quality of life (HRQoL)SF-36Minimal clinically important difference (MCID)
spellingShingle Marte Sævik
Marit Helen Andersen
Jan Otto Beitnes
Lars Aaberge
Per Steinar Halvorsen
Health Related Quality of Life (HRQoL) after transcatheter aortic valve implantation in aortic stenosis patients: exploring a novel threshold for clinically significant improvement after 12 months
Journal of Patient-Reported Outcomes
Aortic stenosis (AS)
Transcatheter aortic valve implantation (TAVI)
Health related quality of life (HRQoL)
SF-36
Minimal clinically important difference (MCID)
title Health Related Quality of Life (HRQoL) after transcatheter aortic valve implantation in aortic stenosis patients: exploring a novel threshold for clinically significant improvement after 12 months
title_full Health Related Quality of Life (HRQoL) after transcatheter aortic valve implantation in aortic stenosis patients: exploring a novel threshold for clinically significant improvement after 12 months
title_fullStr Health Related Quality of Life (HRQoL) after transcatheter aortic valve implantation in aortic stenosis patients: exploring a novel threshold for clinically significant improvement after 12 months
title_full_unstemmed Health Related Quality of Life (HRQoL) after transcatheter aortic valve implantation in aortic stenosis patients: exploring a novel threshold for clinically significant improvement after 12 months
title_short Health Related Quality of Life (HRQoL) after transcatheter aortic valve implantation in aortic stenosis patients: exploring a novel threshold for clinically significant improvement after 12 months
title_sort health related quality of life hrqol after transcatheter aortic valve implantation in aortic stenosis patients exploring a novel threshold for clinically significant improvement after 12 months
topic Aortic stenosis (AS)
Transcatheter aortic valve implantation (TAVI)
Health related quality of life (HRQoL)
SF-36
Minimal clinically important difference (MCID)
url https://doi.org/10.1186/s41687-025-00894-1
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