***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND As  left ventricular assist device ( LVAD ) support duration increases , quality of life ( QoL ) becomes a concern . We review ed the QoL in patients on LVAD support for > or=1 year . METHODS We retrospectively review ed our prospect i ve data base for patients supported > or=1 year by HeartMate pulsatile- ( HM1 ) or continuous-flow ( HM2 ) LVADs from 2000 to 2009 . Transplant or death before 1 year merited exclusion . Metabolic equivalents of tasks ( METs ) , the Minnesota Living with Heart Failure Question naire ( MLHFQ ) , the 6-minute  walk  distance ( 6MWD ) , and New York Heart Association ( NYHA ) class were review ed . Complications and re-admissions were assessed . RESULTS Thirty patients were supported for > or=1 year ( 7 HM1s , 23 HM2s ) . Mean support duration was 594 + /- 173 days . Mean QoL metrics/functional status indicators at 12 months were : 6MWD , 393 + /- 290 m ; MET tolerance , 3.3 + /- 1 ; MLHFQ , 35 + /- 31 ; and NYHA , 1.4 + /- 0.6 . Mean re-admissions/year was 2.9 + /- 2 , with a duration of 13.8 + /- 21 days . Three patients were never re-admitted . Mean out-of-hospital time was 471 + /- 172 days ( 87.3 % of days ) . Infectious complications led to 43 % of re-admissions and occurred in the : drive-line ( 47 % ) at 442 + /- 236 days ; blood ( 37 % ) at 472 + /- 257 days ; and LVAD pocket ( 20 % ) at 550 + /- 202 days . Twenty-three patients ( 77 % ) required additional operations ( 1.7 + /- 1.8/year ) . The most common indication was drive-line infection , but ranged from ischemic bowel to defibrillator exchange . Eight required LVAD exchanges for mechanical ( n = 4 ) , electrical ( n = 3 ) , and thrombotic ( n = 1 ) issues . CONCLUSIONS Although LVAD support is not without complications , patients spend the majority of time outside the hospital enjoying a good quality of life BACKGROUND The HeartMate vented electric left ventricular assist device has been approved for use as destination therapy . Thus , the study of quality -of-life outcomes , as well as morbidity and mortality , is imperative . The purpose of our study was to describe change with time ( from 1 month to 1 year ) in patients who received a HeartMate vented electric left ventricular assist device as a bridge to heart transplantation and to identify quality -of-life predictors of survival after left ventricular assist device implantation . METHODS A nonr and om sample of 78 patients who received a HeartMate vented electric left ventricular assist device ( primarily middle-aged , white married males ) who had quality -of-life data at 1 , 2 , 3 , 6 , 9 , or 12 months after implant was the subject of this report . The sample size decreased with time primarily because of heart transplantation . Patients completed the following booklets of question naires : Quality of Life Index , Rating Question Form , Heart Failure Symptom Checklist , and Sickness Impact Profile . Analyses included both descriptive analyses and modeling procedures ( mixed-effects models and Cox proportional hazards models ) . RESULTS Quality -of-life outcomes were fairly good and stable from 1 month to 1 year after HeartMate vented electric left ventricular assist device implantation . Both positive and negative changes were detected in all quality -of-life domains ( physical and occupational function , social interaction , somatic sensation , and psychological state ) after left ventricular assist device insertion . Items from the physical domain of quality of life , specifically walking and dressing oneself , were significantly associated with the risk of dying after left ventricular assist device implantation . CONCLUSIONS Identifying poor quality -of-life outcomes within 1 year after left ventricular assist device implantation provides direction to develop strategies to improve outcomes . Physical and occupational rehabilitation , psychosocial intervention , and monitoring symptom distress and physical disability may contribute to improved quality -of-life outcomes and survival after left ventricular assist device implantation BACKGROUND Quality of life ( QOL ) outcomes after left ventricular assist device ( LVAD ) implantation from before to after hospital discharge have been examined only in a very small sample of patients . The purpose s of this study are to describe change in QOL from before to after hospital discharge in LVAD patients and to determine whether being discharged with an LVAD predicts better QOL than being hospitalized with an LVAD . METHODS A non-r and om sample of 62 LVAD patients ( approximately 50 years old , male , white , married , fairly well-educated ) completed self-report question naires at > or=2 timepoints post-implant . The question naires ( Quality of Life Index , Rating Question Form , Heart Failure Symptom Checklist , Sickness Impact Profile , LVAD Stressor Scale , Jalowiec Coping Scale ) , which were collated into booklets , had acceptable reliability and validity . Longitudinal analyses were performed in 2 steps using 1- sample t-tests and linear mixed effects modeling . RESULTS Perception of QOL and health status were fairly good both before and after discharge of LVAD patients . Discharge predicted increased satisfaction with socioeconomic areas of life ; decreased overall and psychologic stress and stress related to family and friends , self-care and work/school/finances ; and decreased physical and self-care disability . CONCLUSIONS QOL outcomes improved from before to after hospital discharge in LVAD patients awaiting heart transplantation . As LVADs potentially become available as destination therapy , in addition to being successful bridges to heart transplantation , QOL outcomes will become more important to study Background : Capacity to exercise may not be fully restored in patients with heart failure even in the long term after ventricular assist device ( VAD ) implantation . The benefits of exercise training in patients with VAD are unknown . Design and methods : Fifteen patients , aged 38.3 ± 15.9 years , bridged to heart transplantation with left ventricular assist device or biventricular assist device were r and omized at a ratio of 2 : 1 to a  training group  ( TG , n = 10 ) or a control group ( n = 5 ) , 6.3 ± 4 months after implantation . Both the groups were advised to walk 30–45 min/day . TG also underwent moderate-intensity aerobic exercise using a bike or treadmill for 45 min , three to five times a week , combined with high-intensity inspiratory muscle training using a computer- design ed software to respiratory exhaustion , two to three times a week for 10 weeks . The patients were tested using cardiopulmonary exercise testing , 6-min walk test , spirometry and electronic pressure manometer for inspiratory muscle strength ( Pimax ) and endurance ( sustained Pimax ) measurement . Quality of life was assessed with the Minnesota Living with Heart Failure question naire . Results : TG improved peak oxygen consumption ( 19.3 ± 4.5 vs. 16.8 ± 3.7 ml/kg per min , P = 0.008 ) and VO2 at ventilatory threshold ( 15.1 ± 4.2 vs. 12 ± 5.6 ml/kg per min , P = 0.01 ) , whereas the ventilation/carbon dioxide slope decreased ( 35.9 ± 5.6 vs. 40 ± 6.5 , P = 0.009 ) . The 6-min walk test distance increased ( 527 ± 76 vs. 462 ± 88 m , P = 0.005 ) and quality of life was improved ( 38.2 ± 11.6 vs. 48.9 ± 12.8 , P = 0.005 ) , as well as Pimax ( 131.8 ± 33 vs. 95.5 ± 28cmH2O , P = 0.005 ) , sustained Pimax ( 484 ± 195 vs. 340 ± 193cmH2O/s/10 3 , P = 0.005 ) , and inspiratoty lung capacity ( 2.4 ± 0.9 vs. 1.7 ± 0.7 L , P = 0.008 ) were improved . No significant changes were noted in the control group . Conclusion : Our findings indicate that exercise training may improve the functional status of VAD recipients  even at a later period after implantation and thus , may have additional importance in cases of destination therapy BACKGROUND No studies have analyzed quality of life ( QOL ) from before to after heart transplantation in patients with a left ventricular assist device ( LVAD ) . Therefore , the purpose of this longitudinal , multi-site study was to compare QOL outcomes of patients listed for heart transplantation who required a left ventricular assist device ( LVAD ) at 3 months after implantation of an LVAD vs 3 months after heart transplantation . METHODS A non-r and om sample of 40 patients ( predominantly middle-aged , married , white men ) , who had paired data at both 3 months after LVAD implantation and 3 months after heart transplantation , were investigated . Patients completed self-report question naires ( with acceptable reliability and validity ) at both time periods , including the Quality of Life Index , Rating Question Form , Heart Failure Symptom Checklist , Sickness Impact Profile , LVAD Stressor Scale  ( completed only after LVAD implant ) ,  Heart Transplant Stressor Scale  ( completed only after heart transplant ) and Jalowiec Coping Scale . Descriptive analyses and comparative analyses using paired t-tests were performed with statistical significance set at 0.01 . RESULTS Patients were significantly more satisfied with their lives overall and with their health and functioning at 3 months after heart transplantation as compared with 3 months after LVAD implantation . Mobility , self-care ability , physical ability and overall functional ability improved from 3 months after LVAD implant to 3 months after heart transplant . There was significantly less symptom distress after LVAD implant as compared with after heart transplant for the neurologic , dermatologic and physical sub-scales . Work/school/financial stress was significantly lower after heart transplant vs after LVAD implant . In contrast , 2 other areas of stress were significantly lower after LVAD implant vs after heart transplant : self-care stress and hospital/clinic-related stress . CONCLUSIONS Differences were found in QOL outcomes at 3 months after LVAD implant as compared with 3 months after heart transplant . Our findings point out specific areas of concern with respect to QOL after LVAD implant and post-transplant , some of which are amenable to health-care provider interventions Background —Left ventricular assist devices ( LVADs ) have improved survival in patients with end-stage heart failure . Compared with previous trials , the R and omized Evaluation of Mechanical Assistance in Treatment of Chronic Heart Failure ( REMATCH ) trial enrolled patients with more advanced heart failure and high prevalence of intravenous inotropic therapy . This study analyzes , on a post hoc basis , outcomes in patients undergoing inotropic infusions at r and omization . Methods and Results —Of 129 patients r and omized , 91 were receiving intravenous inotropic therapy at r and omization to LVAD or optimal medical management ( OMM ) .  Mean systolic pressure was 100 versus 107 mm Hg in those not receiving inotropes , serum sodium was 134 versus 137 mEq/L , and left ventricular ejection fraction was 17 % for both groups . LVADs improved survival throughout follow-up for patients undergoing baseline inotropic infusions ( P=0.0014 ) ; for the LVAD group versus the OMM group , respectively , 6-month survival was 60 % versus 39 % , 1-year survival rates were 49 % versus 24 % , and 2-year survival rates were 28 % versus 11 % . For 38 patients not undergoing inotropic infusions , 6-month survival was 61 % for those with LVADs and 67 % for those with OMM , whereas 1-year rates were 57 % and 40 % , respectively ( P=0.55 ) . Quality -of-life scores for survivors improved . Median days out of hospital for patients on inotropic therapy at r and omization were 255 with LVAD and 105 with OMM . Conclusions —Despite severe compromise , patients undergoing inotropic infusions at r and omization derived major LVAD survival benefit with improved quality of life . Patients not undergoing inotropic infusions had higher survival rates both with and without LVAD , but differences did not reach significance . Future studies should prespecify analyses of inotropic and other therapies to determine how disease severity and parallel medical treatment influence the benefits offered by mechanical circulatory support OBJECTIVES This study sought to evaluate the use of a continuous-flow rotary left ventricular assist device ( LVAD ) as a bridge to heart transplantation . BACKGROUND LVAD therapy is an established treatment modality for patients with advanced heart failure . Pulsatile LVADs have limitations in design precluding their use for extended support . Continuous-flow rotary LVADs represent an innovative design with potential for small size and greater reliability by simplification of the pumping mechanism . METHODS In a prospect i ve , 
    Output:
    
Initial evidence suggests an improvement in health status , anxiety , and depression in the first few months after LVAD implantation .
However , PRO scores of patients receiving LVAD therapy are still lower for physical , social , and emotional functioning compared with transplant recipients .
There is a paucity of studies on the patient perspective of LVAD therapy .