Adachi Takeshi, Adachi Shiro, Nakano Yoshihisa, Yasuda Kenichiro, Nishiyama Itsumure, Hirose Miku, Murohara Toyoaki
Department of Cardiology, Nagoya University Hospital Nagoya Japan.
Department of Cardiology, Nagoya University Graduate School of Medicine Nagoya Japan.
Circ Rep. 2024 Feb 20;6(3):80-85. doi: 10.1253/circrep.CR-23-0074. eCollection 2024 Mar 8.
The relationship between the prognosis of patients with both chronic thromboembolic pulmonary hypertension (CTEPH) and a mental disorder (MD) remains unclear. The study group comprised 157 patients with CTEPH who underwent right heart catheterization and were subdivided into 2 groups according to the presence of MDs: MD and non-MD. The patients with MDs were defined as those who had visited a psychiatrist and were under psychotropic drug treatment. The primary outcome was a composite of all-cause death and worsening of PH. The median follow-up period was 1,164 days. The incidence of the primary composite outcome was higher in the MD group than in the non-MD group (24.0% vs. 6.8%), whereas the all-cause mortality rate was comparable between groups (12.0% vs. 6.1%). The mean pulmonary arterial pressure, cardiac index, and pulmonary vascular resistance at baseline were all similar between groups. The Cox proportional hazards model indicated that MD was an independent risk factor for the primary composite outcome (hazard ratio, 2.990; 95% confidence interval, 1.034-8.642). In the present study, concomitant CTEPH and MD was significantly associated with a poor prognosis and such patients should be carefully followed.
慢性血栓栓塞性肺动脉高压（CTEPH）患者与精神障碍（MD）患者的预后关系尚不清楚。研究组包括157例接受右心导管检查的CTEPH患者，根据是否存在精神障碍分为两组：精神障碍组和非精神障碍组。患有精神障碍的患者定义为那些看过精神科医生并正在接受精神药物治疗的患者。主要结局是全因死亡和肺动脉高压恶化的综合情况。中位随访期为1164天。精神障碍组的主要复合结局发生率高于非精神障碍组（24.0%对6.8%），而两组间的全因死亡率相当（12.0%对6.1%）。两组间基线时的平均肺动脉压、心脏指数和肺血管阻力均相似。Cox比例风险模型表明，精神障碍是主要复合结局的独立危险因素（风险比，2.990；95%置信区间，1.034 - 8.642）。在本研究中，CTEPH与精神障碍并存与预后不良显著相关，应对此类患者进行密切随访。
