Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece.
Department of Anesthesiology and Intensive Care Medicine, AHEPA University Hospital, Thessaloniki, Greece.
Heart Lung Circ. 2020 Jan;29(1):142-148. doi: 10.1016/j.hlc.2018.12.005. Epub 2019 Jan 15.
Precapillary pulmonary hypertension (PH) is characterised by compromised functional capacity and impaired quality of life. Assessment of haemodynamics is routinely used for initial diagnosis, follow-up, and risk stratification in these patients. The purpose of this study was to investigate the relation of health-related quality of life (HRQoL) as assessed by emPHasis-10 score, a self-assessment questionnaire assessing breathlessness, fatigue, control, and confidence, to haemodynamic and neurohormonal indices in patients with precapillary PH.
This was a prospective cross-sectional study which included stable patients with precapillary PH. All patients underwent right heart catheterisation, 6-minute walk test, N-terminal pro-brain natriuretic peptide (NT-proBNP) measurement, and assessment of HRQoL with the emPHasis-10 scale.
Overall, 54 patients were included (32 women; mean age, 58.4 ± 14.6 yr). Mean emPHasis-10 score was 19.2 ± 12.0. EmPHasis-10 score correlated with World Health Organization functional class (r = 0.52, p < 0.001), 6-minute walk distance (r=-0.56, p < 0.001), and log(NT-proBNP) (r = 0.41, p < 0.01). A positive correlation of emPHasis-10 score with mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR) and a negative correlation with mixed venous oxygen saturation and cardiac index was observed, after adjustment for age, sex, body mass index, and PH group. In a subgroup analysis of patients with pulmonary arterial hypertension (n = 34) there was a stronger correlation of emPHasis-10 score with mPAP (r = 0.86, p < 0.001) and PVR (r = 0.69, p < 0.01), but no correlation with cardiac index and mixed venous oxygen saturation.
Self-assessment of quality of life with the use of the emPHasis-10 score reflects functional capacity and is correlated with haemodynamic and neurohormonal indices of right heart dysfunction in patients with precapillary PH.
毛细血管前肺动脉高压（PH）的特征是功能能力受损和生活质量下降。血流动力学评估通常用于这些患者的初始诊断、随访和风险分层。本研究的目的是探讨毛细血管前 PH 患者的健康相关生活质量（HRQoL）与血流动力学和神经激素指标的关系，采用 emPHasis-10 评分评估呼吸困难、疲劳、控制和信心。
这是一项前瞻性的横断面研究，包括稳定的毛细血管前 PH 患者。所有患者均行右心导管检查、6 分钟步行试验、N 端脑利钠肽前体（NT-proBNP）测量和 emPHasis-10 量表评估 HRQoL。
共纳入 54 例患者（32 例女性；平均年龄 58.4±14.6 岁）。平均 emPHasis-10 评分为 19.2±12.0。emPHasis-10 评分与世界卫生组织功能分级（r=0.52，p<0.001）、6 分钟步行距离（r=-0.56，p<0.001）和 log（NT-proBNP）（r=0.41，p<0.01）相关。在调整年龄、性别、体重指数和 PH 组后，emPHasis-10 评分与平均肺动脉压（mPAP）和肺血管阻力（PVR）呈正相关，与混合静脉血氧饱和度和心指数呈负相关。在肺动脉高压（n=34）患者的亚组分析中，emPHasis-10 评分与 mPAP（r=0.86，p<0.001）和 PVR（r=0.69，p<0.01）的相关性更强，但与心指数和混合静脉血氧饱和度无相关性。
使用 emPHasis-10 评分进行生活质量自评反映了功能能力，并与毛细血管前 PH 患者右心功能障碍的血流动力学和神经激素指标相关。
