© 2001 European Society of Cardiology
Indicators of myocardial dysfunction and quality of life, one year after acute infarction
a Département d'Information Médicale Hospices Civils de Lyon, Lyon, France
b Service de Cardiologie, Hôpital Cardiologique Hospices Civils de Lyon, Lyon, France
* Corresponding author. Département d'Information Médicale des Hospices Civils de Lyon, Unité de Biostatistique, 162, avenue Lacassagne, 69424 Lyon Cedex 03, France. Tel.: +33-4-72-11-57-72; fax: +33-4-72-11-57-20. E-mail address: rene.ecochard{at}chu-lyon.fr (R. Ecochard)
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Abstract |
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Background: There remains controversy concerning the association between myocardial dysfunction diagnosed soon after acute myocardial infarction (AMI), and subsequent quality of life.
Aims: We searched for a correlation between criteria of myocardial dysfunction assessed within the first month after AMI, and quality of life perceived 1 year later.
Methods: Six hundred and seventy-one patients were followed up and quality of life was assessed using the Nottingham Health Profile. Spearman correlation was used for univariate analyses. A logistic regression identified independent predictors of impaired quality of life.
Results: Patients perceiving inferior quality of life were 61% for energy, 61% for sleep, 49% for physical mobility, 49% for pain, 63% for emotional reactions, and 28% for social isolation. Impaired quality of life was not associated with the initial Killip class. A low ejection fraction was associated with impaired physical mobility (OR = 1.21, 95% CI = 1.05–1.39). Presence of abnormally contracting myocardial segments was associated with impaired mobility (1.40, 1.09–1.80) and with increased pain (1.30, 1.02–1.66). The presence of diseased coronary vessels was associated with pain (1.25, 1.06–1.46).
Conclusion: Myocardial dysfunction was generally associated with impaired quality of life. This has to be considered when assessing improvement of quality of life after medical or surgical treatment of AMI.
Key Words: Heart failure • Myocardial dysfunction • Quality of life • Acute myocardial infarction • Coronary angiography • Nottingham Health Profile
Received October 1, 1999; Revised January 17, 2000; Accepted July 5, 2000
1 The following is a list of PRIMA centres. Isère:Bourgoin-Jallieu, la Côte Saint-André, Grenoble (Centre hospitalier universitaire, Clinique des Eaux Claires), la Mure, le Pont de Beauvoisin, Saint-Laurent du Pont, Saint-Marcellin, Saint-Martin d'Hères, Vienne, Voiron (Centre hospitalier général, Clinique de Chartreuse). Loire: Feurs, Firminy, Montbrison, Rive de Gier, Roanne, Saint-Chamond, Saint-Etienne (Clinique la Croix, Hôpital Bellevue, Hôpital de la Charit, Hôpital Nord, Hôpital de Saint-Jean-Bonnefond, Polyclinique Beaulieu), Saint-Galmier, Saint-Just et Saint-Rambert. Rhône: Condrieu, Givors, Lyon and surroundings (Centre hospitalier Lyon-Sud, Clinique Charcot, Clinique du Grand Large, Clinique des Minguettes, Clinique Mutualiste E. André, Clinique de la Roseraie, Clinique de la Sauvegarde, Clinique du Tonkin, Hôpital Cardiovasculaire et Pneumologique, Hôpital A. Charrial, Hôpital de la Croix-Rousse, Hôpital Desgenettes, Hôpital E. Herriot, Hôpital de l'Hôtel-Dieu, Hôpital de Sainte-Foy-lès-Lyon, Hôpital Saint Joseph, Infirmerie protestante, Polyclinique de Rillieux), Tarare, Villefranche-sur-Saône. Co-ordinating center: F. Delahaye, C. Colin, R. Ecochard, and G. de Gevigney.
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