Background: Despite evidence from the broader caregiving literature about the interdependent nature of the caregiving dyad, few studies in heart failure (HF) have examined associations between caregiver and patient characteristics.Objective: The aim of this study is to quantitatively synthesize the relationships between caregiver well-being and patient outcomes.Methods: The MEDLINE, PsycINFO, and CINAHL databases were searched for studies of adult HF patients and informal caregivers that tested the relationship between caregiver well-being (perceived strain and psychological distress) and patient outcomes of interest. Summary effects across studies were estimated using random effects meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Results: A total of 15 articles meeting inclusion criteria were included in the meta-analysis. Taking into account differences across studies, higher caregiver strain was associated significantly with greater patient symptoms (Fisherz= 0.22,P< .001) and higher caregiver strain was associated significantly with lower patient quality of life (Fisherz= −0.36,P< .001). Relationships between caregiver psychological distress and both patient symptoms and quality of life were not significant. Although individual studies largely found significant relationships between worse caregiver well-being and higher patient clinical event-risk, these studies were not amenable to meta-analysis because of substantial variation in event-risk measures.Conclusions: Clinical management and research approaches that acknowledge the interdependent nature of the caregiving dyad hold great potential to benefit both patients and caregivers.

Treatment of heart failure (HF) is particularly complex in the presence of comorbidities. We sought to identify and associate comorbidity profiles with inpatient outcomes during HF hospitalizations.

Background: Although current guidelines emphasize the importance of social support to the success of left ventricular assist device ( LVAD ) therapy, few studies examine the influence of the caregiver on patient outcomes or quantify the impact of LVAD caregiving on caregiver outcomes. The purpose of this analysis was to identify patient and caregiver determinants of patient quality of life ( QOL ) and caregiver strain in response to LVAD therapy. Methods and Results: Data on patients receiving LVAD therapy and their caregivers (n=50 dyads) were prospectively collected pre‐implantation and 1, 3, and 6 months post‐implantation. Growth curve modeling was used to describe change in patient QOL (Kansas City Cardiomyopathy Questionnaire) and caregiver strain (Multidimensional Caregiver Strain Index). Patient QOL improved most in the first month (β=23.22±3.76, P <0.001), followed by gradual gains over 6 months (β=1.90±0.64, P <0.01). Caregivers experienced worsening of strain in the first month (β=4.30±1.42, P <0.01), followed by gradual resolution to pre‐implantation levels by 6 months (β=−0.71±0.23, P <0.01). Worse pre‐implantation patient symptoms were associated with greater improvement in patient QOL (β=0.53±0.19, P <0.01) but worsening caregiver strain (β=0.15±0.07, P =0.04). Better relationship quality was associated with greater improvement in patient QOL (β=14.39±5.85, P =0.01) and less pre‐implantation caregiver strain (β=−9.31±2.28, P <0.001). Nonspousal caregivers experienced less pre‐implantation strain (β=−8.60±3.10, P =0.01), and patients with nonspousal caregivers had less improvement in QOL (β=−3.70±1.62, P =0.02). Conclusions: A combination of patient and caregiver characteristics predicts patient and caregiver response to LVAD therapy. Including caregiver factors in future studies may be helpful in developing interventions that improve patient and caregiver outcomes, together.