Department of Rehabilitation Kyorin University Hospital Tokyo Japan.
Department of Cardiovascular Medicine Kyorin University Hospital Tokyo Japan.
J Am Heart Assoc. 2022 Sep 6;11(17):e026400. doi: 10.1161/JAHA.122.026400. Epub 2022 Sep 3.
Background Whether pulmonary hemodynamic parameters and functional capacity are associated with quality of life in patients with chronic thromboembolic pulmonary hypertension remains unknown. This study aimed to evaluate disease-specific quality of life using the emPHasis-10 questionnaire and assess its determinants in patients with chronic thromboembolic pulmonary hypertension with normalized pulmonary hemodynamics. Methods and Results This cross-sectional study included 187 health status assessments of 143 patients with chronic thromboembolic pulmonary hypertension (median age, 68 [58-75] years; men/women, 51/136; use of home oxygen therapy, 51 patients [27%]) after balloon pulmonary angioplasty with normalized mean pulmonary artery pressure <25 mm Hg at rest. Right heart catheterization was performed, followed by assessment of 6-minute walk distance and the emPHasis-10 questionnaire. The median pulmonary artery pressure and pulmonary vascular resistance were 18 (15-21) mm Hg and 2.2 (1.7-2.9) wood units, respectively. The median emPHasis-10 score was 14 (8-24), whereas the median 6-minute walk distance was 447 (385-517) m. Univariate linear regression analysis showed that the emPHasis-10 score was associated with 6-minute walk distance (β=-0.476 [95% CI -0.604, -0.348], <0.001) and home oxygen therapy (β=0.214 [95% CI, 0.072, 0.356], =0.003) but not with hemodynamic parameters. Multiple regression analysis revealed that a higher emPHasis-10 score was associated with lower 6-minute walk distance (β=-0.475 [95% CI, -0.631 to -0.319], <0.001). Conclusions Health-related quality of life was associated with exercise capacity and the use of home oxygen therapy, but not with hemodynamic parameters, in patients with chronic thromboembolic pulmonary hypertension and normalized hemodynamics after balloon pulmonary angioplasty. Improvements in exercise capacity may lead to further improvements in quality of life.
目前尚不清楚慢性血栓栓塞性肺动脉高压患者的肺血流动力学参数和功能能力是否与生活质量相关。本研究旨在使用 emPHasis-10 问卷评估慢性血栓栓塞性肺动脉高压患者的特定疾病生活质量，并评估其在经球囊肺动脉成形术后肺血流动力学正常化的慢性血栓栓塞性肺动脉高压患者中的决定因素。
本横断面研究纳入了 143 例慢性血栓栓塞性肺动脉高压患者（中位年龄 68 [58-75] 岁；男性/女性 51/136；51 例[27%]使用家庭氧疗）的 187 次健康状况评估。在 rest 时平均肺动脉压<25mm Hg 后进行右心导管检查，然后评估 6 分钟步行距离和 emPHasis-10 问卷。肺动脉压和肺血管阻力中位数分别为 18（15-21）mmHg 和 2.2（1.7-2.9）wood 单位。emPHasis-10 评分中位数为 14（8-24），而 6 分钟步行距离中位数为 447（385-517）m。单因素线性回归分析显示，emPHasis-10 评分与 6 分钟步行距离（β=-0.476[95%CI-0.604，-0.348]，<0.001）和家庭氧疗（β=0.214[95%CI，0.072，0.356]，=0.003）相关，但与血流动力学参数无关。多因素回归分析显示，较高的 emPHasis-10 评分与 6 分钟步行距离较短（β=-0.475[95%CI-0.631 至-0.319]，<0.001）相关。
在经球囊肺动脉成形术后肺血流动力学正常化的慢性血栓栓塞性肺动脉高压患者中，健康相关生活质量与运动能力和家庭氧疗相关，但与血流动力学参数无关。运动能力的改善可能会进一步提高生活质量。
