{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T10:00:27Z","timestamp":1789984827865,"version":"4.0.1"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Health-related quality of life (HRQOL) is a key consideration among older patients with heart failure considering advanced therapies. We evaluated change in HRQOL from before to 24 months after heart transplantation (HT) or long-term mechanical circulatory support (MCS) among older (60\u201380 years) patients and identified factors associated with HRQOL changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Data for this observational study were collected from 13 US sites via patient self-reported measures (EuroQol-5-dimension-3L visual analog scale score: 0=worst\u2013100=best imaginable health state and dimension scores; Kansas City Cardiomyopathy Questionnaire-12 overall summary score\/domain scores: 0\u2013100, higher=better health status; other measures) and a 6-minute walk test. Analyses included multivariable linear mixed-effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Of 393 enrollees, 305 underwent surgery: HT with pretransplant MCS (HT MCS)=69, HT without pretransplant MCS (HT non-MCS)=92, and long-term MCS=144. Cohort average age=66.9\u00b14.7 years, 78% male, 83% White, 78% married\/partnered, and 71% with &gt;high school education. HT non-MCS and long-term MCS groups experienced significant improvement in average visual analog scale scores within 6 months after surgery, sustained through 24 months of follow-up; the HT MCS group EuroQol-5-dimension-3L baseline visual analog scale score was higher than those of the other 2 groups and did not improve significantly through 24 months of follow-up. The average Kansas City Cardiomyopathy Questionnaire-12 overall summary score improved in all 3 groups (baseline\u20136 months, sustained through 24 months). Compared with HT non-MCS, the main effect of long-term MCS showed decrements of \u221211.2 (\u221217.3 to \u22125.1;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001) points in Kansas City Cardiomyopathy Questionnaire-12 overall summary score and of \u22129.9 (\u221216.1 to \u22123.8;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.002) points in EuroQol-5-dimension-3L visual analog scale.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>HT MCS improvement in HRQOL varied by measure; HT non-MCS and long-term MCS improvement occurred through 24 months, regardless of measure. Domains of HRQOL improved after these surgeries, varying by surgical strategy and postoperative time period. Long-term MCS was associated with a decrease in HRQOL across time. These findings provide important information for patients considering treatment options.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circheartfailure.125.013871","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T09:00:19Z","timestamp":1789981219000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Health-Related Quality of Life in Older Patients With Advanced Heart Failure From Before to 2 Years After Heart Transplantation or Long-Term Mechanical Circulatory Support: Findings From the SUSTAIN-IT Study"],"prefix":"10.1161","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6570-5365","authenticated-orcid":true,"given":"Kathleen L.","family":"Grady","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2839-2611","authenticated-orcid":true,"given":"John A.","family":"Spertus","sequence":"additional","affiliation":[{"name":"University of Missouri \u2013 Kansas City Healthcare Institute for Innovations in Quality and Saint Luke\u2019s Mid America Heart Institute (J.A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4666-1870","authenticated-orcid":true,"given":"Mary Amanda","family":"Dew","sequence":"additional","affiliation":[{"name":"University of Pittsburgh, PA (M.A.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2816-6590","authenticated-orcid":true,"given":"Tingqing","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1847-5218","authenticated-orcid":true,"given":"Scott","family":"Silvestry","sequence":"additional","affiliation":[{"name":"University of Arizona, Tucson (S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryl","family":"Johnson","sequence":"additional","affiliation":[{"name":"University of Wisconsin, Madison (M.J., M.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6420-0480","authenticated-orcid":true,"given":"Eileen","family":"Hsich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3368-7473","authenticated-orcid":true,"given":"Brent","family":"Lampert","sequence":"additional","affiliation":[{"name":"Ohio State University, Columbus (B.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8705-7549","authenticated-orcid":true,"given":"Michael","family":"Petty","sequence":"additional","affiliation":[{"name":"University of Minnesota Medical Center, Fairview 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