Quality of Life in Adults with Tetralogy of Fallot: Physical Limitations and Psychological Well-Being

<b>Background:</b> Advances in medical care of patients with tetralogy of Fallot (ToF) have significantly altered the natural course of the disease by prolonging life. Thus, our focus has now shifted to exploring the health-related quality of life (HRQoL) of those patients. This study so...

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Main Authors: Panagiotis Zachos, Evelina Pappa, Nikias Milaras, Vasileios Nevras, Paschalis Karakasis, Nikolaos Ktenopoulos, Maria Karakosta, Alkistis-Eleni Kalesi, Nearchos Kasinos, Anastasios Theodosis Georgilas, Stefanos Despotopoulos, Sotiria Apostolopoulou, Dimitrios Niakas
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Journal of Cardiovascular Development and Disease
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Online Access:https://www.mdpi.com/2308-3425/12/5/178
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author Panagiotis Zachos
Evelina Pappa
Nikias Milaras
Vasileios Nevras
Paschalis Karakasis
Nikolaos Ktenopoulos
Maria Karakosta
Alkistis-Eleni Kalesi
Nearchos Kasinos
Anastasios Theodosis Georgilas
Stefanos Despotopoulos
Sotiria Apostolopoulou
Dimitrios Niakas
author_facet Panagiotis Zachos
Evelina Pappa
Nikias Milaras
Vasileios Nevras
Paschalis Karakasis
Nikolaos Ktenopoulos
Maria Karakosta
Alkistis-Eleni Kalesi
Nearchos Kasinos
Anastasios Theodosis Georgilas
Stefanos Despotopoulos
Sotiria Apostolopoulou
Dimitrios Niakas
author_sort Panagiotis Zachos
collection DOAJ
description <b>Background:</b> Advances in medical care of patients with tetralogy of Fallot (ToF) have significantly altered the natural course of the disease by prolonging life. Thus, our focus has now shifted to exploring the health-related quality of life (HRQoL) of those patients. This study sought to explore the HRQoL of adult patients operated on for ToF using two validated instruments—the SF-36 and EQ-5D—that highlight both physical and mental aspects of the disease. <b>Methods:</b> A total of 115 individuals (53 ToF patients and 60 healthy controls) were recruited for the purposes of this study. HRQoL was assessed through the SF-36 and EQ-5D instruments. Comparisons were made between ToF patients and controls with subgroup analyses based on sex and age. <b>Results:</b> ToF patients reported significantly poorer HRQoL in the physical domains, namely Physical Functioning, Role Physical, General Health, and Physical Component Summary of the SF-36 when compared to controls (<i>p</i> < 0.05). Interestingly, there was a trend towards lower Bodily Pain and better Vitality scores in ToF subjects. Age influenced HRQoL, with older respondents rating their physical health lower than younger patients and controls (<i>p</i> < 0.05). EQ-5D VAS scores indicated that ToF patients perceived their overall health worse than controls (80.02 vs. 86.92, <i>p</i> < 0.001), with Anxiety/Depression being the most frequently reported problem (45.3%). Controls reported better HRQoL than ToF patients across all SF-36 domains in both health states (EQ-5D = 1 and EQ-5D > 1), except for Bodily Pain and Vitality in EQ-5D = 1. Significant differences were observed in Physical Functioning, Role Physical, General Health, Vitality, and Physical Component Score. Notably, ToF patients with EQ-5D = 1 showed unexpectedly higher Vitality scores than controls; however, this advantage diminished significantly in the EQ-5D > 1 group. <b>Conclusions:</b> Adult ToF survivors experience significant physical limitations as expected, while mental health seems to remain relatively unaffected compared to healthy peers. These findings underscore the importance of HRQoL assessment in patients with congenital heart disease and the need for disease-specific HRQoL instruments.
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spelling doaj-art-e6356dbe571948d99d8bdd616004435d2025-08-20T02:33:54ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252025-05-0112517810.3390/jcdd12050178Quality of Life in Adults with Tetralogy of Fallot: Physical Limitations and Psychological Well-BeingPanagiotis Zachos0Evelina Pappa1Nikias Milaras2Vasileios Nevras3Paschalis Karakasis4Nikolaos Ktenopoulos5Maria Karakosta6Alkistis-Eleni Kalesi7Nearchos Kasinos8Anastasios Theodosis Georgilas9Stefanos Despotopoulos10Sotiria Apostolopoulou11Dimitrios Niakas12Department of Health Economics, School of Medicine, National and Kapodistrian University of Athens, 10679 Athens, GreeceFaculty of Social Sciences, Hellenic Open University, Riga Fereou 169 & Tsamadou, 26222 Patras, GreeceMedical School, National and Kapodistrian University of Athens, Vasilissis Sofias 114, 10679 Athens, GreeceCardiology Department, General Hospital of Karditsa, Tavropou (Terma), 43100 Karditsa, GreeceMedical School, National and Kapodistrian University of Athens, Vasilissis Sofias 114, 10679 Athens, GreeceMedical School, National and Kapodistrian University of Athens, Vasilissis Sofias 114, 10679 Athens, GreeceEchocardiography Training Center “D. Beldekos”, Cardiology Department, Tzaneio General Hospital of Pireaus, 18536 Attica, GreeceEchocardiography Training Center “D. Beldekos”, Cardiology Department, Tzaneio General Hospital of Pireaus, 18536 Attica, GreeceEchocardiography Training Center “D. Beldekos”, Cardiology Department, Tzaneio General Hospital of Pireaus, 18536 Attica, GreeceEchocardiography Training Center “D. Beldekos”, Cardiology Department, Tzaneio General Hospital of Pireaus, 18536 Attica, GreecePediatric Cardiology and Adult Congenital Heart Disease Department, Onassis Cardiac Surgery Center, 17674 Kallithea, GreecePediatric Cardiology and Adult Congenital Heart Disease Department, Onassis Cardiac Surgery Center, 17674 Kallithea, GreeceDepartment of Health Economics, School of Medicine, National and Kapodistrian University of Athens, 10679 Athens, Greece<b>Background:</b> Advances in medical care of patients with tetralogy of Fallot (ToF) have significantly altered the natural course of the disease by prolonging life. Thus, our focus has now shifted to exploring the health-related quality of life (HRQoL) of those patients. This study sought to explore the HRQoL of adult patients operated on for ToF using two validated instruments—the SF-36 and EQ-5D—that highlight both physical and mental aspects of the disease. <b>Methods:</b> A total of 115 individuals (53 ToF patients and 60 healthy controls) were recruited for the purposes of this study. HRQoL was assessed through the SF-36 and EQ-5D instruments. Comparisons were made between ToF patients and controls with subgroup analyses based on sex and age. <b>Results:</b> ToF patients reported significantly poorer HRQoL in the physical domains, namely Physical Functioning, Role Physical, General Health, and Physical Component Summary of the SF-36 when compared to controls (<i>p</i> < 0.05). Interestingly, there was a trend towards lower Bodily Pain and better Vitality scores in ToF subjects. Age influenced HRQoL, with older respondents rating their physical health lower than younger patients and controls (<i>p</i> < 0.05). EQ-5D VAS scores indicated that ToF patients perceived their overall health worse than controls (80.02 vs. 86.92, <i>p</i> < 0.001), with Anxiety/Depression being the most frequently reported problem (45.3%). Controls reported better HRQoL than ToF patients across all SF-36 domains in both health states (EQ-5D = 1 and EQ-5D > 1), except for Bodily Pain and Vitality in EQ-5D = 1. Significant differences were observed in Physical Functioning, Role Physical, General Health, Vitality, and Physical Component Score. Notably, ToF patients with EQ-5D = 1 showed unexpectedly higher Vitality scores than controls; however, this advantage diminished significantly in the EQ-5D > 1 group. <b>Conclusions:</b> Adult ToF survivors experience significant physical limitations as expected, while mental health seems to remain relatively unaffected compared to healthy peers. These findings underscore the importance of HRQoL assessment in patients with congenital heart disease and the need for disease-specific HRQoL instruments.https://www.mdpi.com/2308-3425/12/5/178tetralogy of Fallothealth-related quality of lifeSF-36EQ-5Dadult congenital heart diseasephysical functioning
spellingShingle Panagiotis Zachos
Evelina Pappa
Nikias Milaras
Vasileios Nevras
Paschalis Karakasis
Nikolaos Ktenopoulos
Maria Karakosta
Alkistis-Eleni Kalesi
Nearchos Kasinos
Anastasios Theodosis Georgilas
Stefanos Despotopoulos
Sotiria Apostolopoulou
Dimitrios Niakas
Quality of Life in Adults with Tetralogy of Fallot: Physical Limitations and Psychological Well-Being
Journal of Cardiovascular Development and Disease
tetralogy of Fallot
health-related quality of life
SF-36
EQ-5D
adult congenital heart disease
physical functioning
title Quality of Life in Adults with Tetralogy of Fallot: Physical Limitations and Psychological Well-Being
title_full Quality of Life in Adults with Tetralogy of Fallot: Physical Limitations and Psychological Well-Being
title_fullStr Quality of Life in Adults with Tetralogy of Fallot: Physical Limitations and Psychological Well-Being
title_full_unstemmed Quality of Life in Adults with Tetralogy of Fallot: Physical Limitations and Psychological Well-Being
title_short Quality of Life in Adults with Tetralogy of Fallot: Physical Limitations and Psychological Well-Being
title_sort quality of life in adults with tetralogy of fallot physical limitations and psychological well being
topic tetralogy of Fallot
health-related quality of life
SF-36
EQ-5D
adult congenital heart disease
physical functioning
url https://www.mdpi.com/2308-3425/12/5/178
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