Decline in Quality of Life in Older Patients with Congenital Heart Disease: A Cross Sectional Study in 2360 Patients

Objective: Assessing Quality of life (QoL) is frequently used to involve patients with congenital heart diseases (CHD) in the process of decision making as well as in the outcome evaluation. Methodological heterogeneities, assessment in different age and diagnostic subgroups led to controversial findings. This study aims to give a comprehensive answer to the health-related QoL in patients with CHD.

Patients and Methods: From July 2001 to June 2013, 2360 patients (1058 female, 28.6 ± 11.2 years, range 14-75 years) with various kinds of CHD underwent a quality of life assessment with the SF-36 questionnaire in our institution as part of their routine follow-up. In addition, they performed a cardiopulmonary exercises test.

Results: Physical component summary (PCS) develops from 96.1% predicted in patients younger than 20 years, to 96.2% predicted in patients aged 20 to 30 years, 92.3% predicted in patients aged 30 to 40 years, and 92.6% predicted in patients 40 years or older (r=-.114; p<.001). The decline in the more mental domains of quality of life (MCS) was more prominent from 104.1% predicted in patients younger than 20 years, to 103.4% predicted, 99.9% predicted, and 97.5% predicted (r=-.132; p<.001). Exercise capacity was impaired with 80.1 ± 23.0% predicted and also declined slowly with age (r=-.084; p<.001).

Conclusions: QoL in patients with CHD is good but deteriorates with proceeding age. The decline is small and more prominent in the mental components of QoL but should not be neglected in the clinical treatment of the aging population of patients with CHD.