Health-Related Quality of Life Across the Spectrum of Pulmonary Hypertension.
health-related quality of life
pulmonary hypertension
Journal
Chest
ISSN: 1931-3543
Titre abrégé: Chest
Pays: United States
ID NLM: 0231335
Informations de publication
Date de publication:
12 Feb 2024
12 Feb 2024
Historique:
received:
23
07
2023
revised:
05
01
2024
accepted:
08
02
2024
medline:
15
2
2024
pubmed:
15
2
2024
entrez:
14
2
2024
Statut:
aheadofprint
Résumé
Health related quality of life (HRQOL) is frequently impaired in pulmonary arterial hypertension (PAH). However, little is known about HRQOL in other forms of pulmonary hypertension (PH). Does HRQOL vary across groups of the World Symposium on Pulmonary Hypertension (WSPH) classification system? This cross-sectional study included PH patients from PVDOMICS (Pulmonary Vascular Disease Phenomics). HRQOL was assessed using emPHasis-10 (e-10), Medical Outcomes Survey Short Form-36 (SF-36; physical component (PCS) and mental component (MCS)), and Minnesota Living with Heart Failure Questionnaire (MLHF). Pearson's correlations between HRQOL and demographic, physiologic, and imaging characteristics within each WSPH group were tested. Multivariable linear regressions compared HRQOL across WSPH groups adjusting for demographics, disease prevalence, functional class, and hemodynamics. Cox proportional hazard models were used to assess associations between HRQOL and survival across WSPH groups. Among 691 PH patients, HRQOL correlated with functional class and six-minute walk distance but not hemodynamics. HRQOL was severely depressed across WSPH groups for all measures except the SF-36 MCS. When compared to Group 1, Group 2 subjects had significantly worse HRQOL (e-10: 29 vs 24, p=0.001, PCS: 32.9 ± 8 vs 38.4 ± 10, p<0.0001, MLHF: 50 vs 38, p=0.003). Group 3 subjects similarly had worse e-10 (31 vs 24, p<0.0001) and PCS scores (33.3 ± 9 vs 38.4 ± 10, p<0.0001) compared to Group 1, which persisted in multivariable models (p<0.05). HRQOL was associated in adjusted models with survival across Groups 1, 2, and 3. HRQOL is depressed in PH and particularly in Groups 2 and 3 despite less severe hemodynamics. HRQOL is associated with functional capacity, but hemodynamic disease severity poorly estimates the impact of PH on patient's lives. Further studies are needed to better identify predictors and treatments to improve HRQOL across the spectrum of pulmonary hypertension.
Sections du résumé
BACKGROUND
BACKGROUND
Health related quality of life (HRQOL) is frequently impaired in pulmonary arterial hypertension (PAH). However, little is known about HRQOL in other forms of pulmonary hypertension (PH).
RESEARCH QUESTION
OBJECTIVE
Does HRQOL vary across groups of the World Symposium on Pulmonary Hypertension (WSPH) classification system?
STUDY DESIGN AND METHODS
METHODS
This cross-sectional study included PH patients from PVDOMICS (Pulmonary Vascular Disease Phenomics). HRQOL was assessed using emPHasis-10 (e-10), Medical Outcomes Survey Short Form-36 (SF-36; physical component (PCS) and mental component (MCS)), and Minnesota Living with Heart Failure Questionnaire (MLHF). Pearson's correlations between HRQOL and demographic, physiologic, and imaging characteristics within each WSPH group were tested. Multivariable linear regressions compared HRQOL across WSPH groups adjusting for demographics, disease prevalence, functional class, and hemodynamics. Cox proportional hazard models were used to assess associations between HRQOL and survival across WSPH groups.
RESULTS
RESULTS
Among 691 PH patients, HRQOL correlated with functional class and six-minute walk distance but not hemodynamics. HRQOL was severely depressed across WSPH groups for all measures except the SF-36 MCS. When compared to Group 1, Group 2 subjects had significantly worse HRQOL (e-10: 29 vs 24, p=0.001, PCS: 32.9 ± 8 vs 38.4 ± 10, p<0.0001, MLHF: 50 vs 38, p=0.003). Group 3 subjects similarly had worse e-10 (31 vs 24, p<0.0001) and PCS scores (33.3 ± 9 vs 38.4 ± 10, p<0.0001) compared to Group 1, which persisted in multivariable models (p<0.05). HRQOL was associated in adjusted models with survival across Groups 1, 2, and 3.
INTERPRETATION
CONCLUSIONS
HRQOL is depressed in PH and particularly in Groups 2 and 3 despite less severe hemodynamics. HRQOL is associated with functional capacity, but hemodynamic disease severity poorly estimates the impact of PH on patient's lives. Further studies are needed to better identify predictors and treatments to improve HRQOL across the spectrum of pulmonary hypertension.
Identifiants
pubmed: 38354903
pii: S0012-3692(24)00155-7
doi: 10.1016/j.chest.2024.02.009
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024. Published by Elsevier Inc.