Key result
Surgical aortic valve replacement in patients over 70 years of age significantly improved mood, with mean GDS scores decreasing from 12.6 at baseline to 4.6 at 12 months (p<0.0001), alongside improvements in physical performance and quality of life.
Why the study?
Although SAVR is the gold standard for treating aortic valve stenosis and widely examined for perioperative mortality, its impact on overall health has received much less attention.
Does surgical aortic valve replacement improve physical performance, cognitive function, and health-related quality of life in elderly patients with severe aortic valve stenosis?
Observational (n=35)
No
Does surgical aortic valve replacement improve physical performance, cognitive function, and health-related quality of life in elderly patients with severe aortic valve stenosis?
Absolute Event Rate: 4.6% vs 12.6%
p-value: p=<0.0001
In elderly patients with severe aortic stenosis, surgical aortic valve replacement significantly improves physical performance, mood, and quality of life at 1 year, despite a transient decline in nutritional status and a long-term decline in cognitive function.
AVR associated with mood and QoL gains in elderly AS; hypothesis-generating and requires RCTs before practice change.
BACKGROUND: Surgical aortic valve replacement (SAVR) is still the gold standard for treating aortic valve stenosis (AVS). Its effectiveness has been extensively examined in terms of perioperative mortality, but its impact on overall health has received much less attention. AIMS: To assess the physical performance, cognitive status, and health-related quality of life of elderly patients undergoing SAVR, in the short, medium and long term. METHODS: This single-center prospective study enrolled patients aged > 70 years who underwent isolated SAVR for severe AVS. Data were collected on each participant's clinical status, physical performance, cognitive status, mood, and health-related quality of life. This multidimensional geriatric assessment was performed before surgery (T0), and again at 45 days (T1), 3 months (T2), 6 months (T3), and 12 months (T4) post-surgery. Baseline (T0) and follow-up (T2-T4) data were compared separately for patients grouped by gender using paired t-tests. RESULTS: Data from a total of 35 patients were analyzed. Compared with the baseline (T0), nutritional status worsened at T1, then gradually improved through to T4. Physical performance, mood, and health-related quality of life improved significantly after surgery. Cognitive function showed no change through to T3, but then deteriorated at T4. CONCLUSIONS: Our results show that SAVR in patients over 70 years of age has a positive impact on nutrition, mood, and health-related quality of life. Cognitive function was not negatively affected in the short and medium term, although it deteriorated in the long term. SAVR also had a positive impact on the physical performance of our sample.
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Tarzia et al. (2021) conducted an observational in Severe symptomatic aortic valve stenosis (n=35). Surgical aortic valve replacement (SAVR) vs. Baseline (pre-surgery) was evaluated on Geriatric Depression Scale (GDS) score at 12 months (p=<0.0001). Surgical aortic valve replacement in patients over 70 years of age significantly improved mood, with mean GDS scores decreasing from 12.6 at baseline to 4.6 at 12 months (p<0.0001), alongside improvements in physical performance and quality of life.
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