Regional Competency Centre for PAH, CHU Arnaud de Villeneuve, Montpellier, France; Department of Respiratory Diseases, CHU Arnaud de Villeneuve, Montpellier, France.
Department Medical Information, Montpellier University Hospitals, Montpellier, France.
J Psychosom Res. 2018 Feb;105:45-51. doi: 10.1016/j.jpsychores.2017.12.003. Epub 2017 Dec 6.
Pulmonary arterial hypertension (PAH) is a rare and life-threatening disease well-marked by under diagnosis, delayed diagnosis and atypical treatments. Few data are available on the quality of life (QoL) and psychosocial characteristics of patients with PAH. Our aim is to describe the impact of psychological factors on the health-related quality of life (HRQoL) of treated PAH patients in a cross-sectional study.
Consecutive patients presenting at our Competency Centre for PAH were recruited. The aetiology, New York Heart Association (NYHA) stage, haemodynamics, 6-min walk distance (6MWD), delta SPO (Pulse oximeter oxygen saturation; baseline lowest value during 6-min walk test (6MWT), current treatments and psychological history were recorded. HRQoL, anxiety, depression and coping strategies were explored using self-administered questionnaires (SF-36, HADS, STAI-Y, CHIP and WCC).
A total of 55 patients were included. The HRQoL of PAH patients was poor with altered results on several scales. Anxiety and depression were high and coping was focused on medical information strategies. Multivariate analysis indicated a positive relationship between 6MWD and the Physical Composite Score for QoL (p=0.004), as well as a negative relationship between delta SPO and the Mental Composite Score (p=0.02), irrespective of other known prognostic factors (such as haemodynamics at right heart catheterization). Depression and Trait-Anxiety were associated with a lower physical (p=0.001) and mental (p<0.001) QoL, respectively.
Psychological factors impact the HRQoL of treated patients. A longitudinal and qualitative study should refine these results.
Clinical trial N°: NCT01380054.
肺动脉高压（PAH）是一种罕见且危及生命的疾病，其特点是诊断不足、诊断延迟和治疗不规范。关于 PAH 患者的生活质量（QoL）和心理社会特征的数据很少。我们的目的是在一项横断面研究中描述心理因素对接受治疗的 PAH 患者健康相关生活质量（HRQoL）的影响。
连续招募在我们的 PAH 能力中心就诊的患者。记录病因、纽约心脏协会（NYHA）分期、血液动力学、6 分钟步行距离（6MWD）、Δ SPO（脉搏血氧仪氧饱和度；6MWT 期间的最低基线值）、当前治疗和心理病史。使用自我管理问卷（SF-36、HADS、STAI-Y、CHIP 和 WCC）探讨 HRQoL、焦虑、抑郁和应对策略。
共纳入 55 例患者。PAH 患者的 HRQoL 较差，多个量表结果改变。焦虑和抑郁程度较高，应对策略侧重于医疗信息。多变量分析表明，6MWD 与生活质量的身体综合评分呈正相关（p=0.004），Δ SPO 与心理综合评分呈负相关（p=0.02），而与其他已知的预后因素（如右心导管检查时的血液动力学）无关。抑郁和特质焦虑与较低的身体（p=0.001）和心理（p<0.001）QoL 相关。
心理因素影响接受治疗的患者的 HRQoL。应进行纵向和定性研究以完善这些结果。
NCT01380054。
