Long-term effects of heart transplantation: The gap between physical performance and emotional well-being

The purpose of our study was to assess physical and emotional factors In he art transplant patients. A prospective design was used to compare patients' physical symptoms, emotional complaints, and restrictions at admission to the waiting list, immediately after, and 1 and 5 years after heart transpla ntation. Thirty-three patients were included (30 male, 3 female) in the stu dy, Their mean age at admission was 48 +/- 10.2 years. Of these, 23 suffere d from cardiomyopathy, 8 from coronary heart disease, and 2 from, valvular insufficiency. At admission, the patients suffered from symptoms of cardiac insufficiency, and were restricted in sports, gardening, hobbies, sexual l ife, job, food-intake, and mobility. More than three-fourths rated their ph ysical and emotional status as moderate to poor. Emotionally, they suffered from irritability, restlessness, depression, psychic lability, lowered dri ve, lack of social contact, low self-esteem, and anxiety. At the end of reh abilitation (4-8 weeks after the operation), all physical and emotional com plaints, as well as restrictions had significantly decreased (p < 0.0001 to p<0.001), except for trembling, numbness of hands/feet, and food-intake. O ne year postoperatively, patients reported even fewer physical complaints ( p < 0.01). Three-fourths rated their physical and emotional status good or excellent. Five years postoperatively-in contrast to physical status, restr ictions, and physical complaints-the emotional complaints had increased sig nificantly (p< 0.0001). Patients reported excellent physical performance up to 5 years postoperatively. On the other hand, the study revealed that the ir emotional well-being had significantly deteriorated from 1 to 5 years po stoperatively. Attention should, therefore, not only be paid to the good ph ysical health of the survivors, but also to the worsening of their emotiona l status.