Raguragavan Aarohanan, Jayabalan Dujinthan, Dhakal Sugam, Saxena Akshat
Medical School University of Western Australia Nedlands Western Australia Australia.
Department of Hepatology Sir Charles Gairdner Hospital Nedlands Western Australia Australia.
Pulm Circ. 2024 Jul 1;14(3):e12407. doi: 10.1002/pul2.12407. eCollection 2024 Jul.
Pulmonary thromboendarterectomy (PTE) is the current gold standard treatment for chronic thromboembolic pulmonary hypertension (CTEPH) and is a viable treatment option for chronic thromboembolic pulmonary disease (CTEPD). The progressive nature of both diseases severely impacts health-related quality of life (HRQoL) across a variety of domains. This systematic review was performed to evaluate the impact of PTE on short- and long-term HRQoL. A literature search was conducted on PubMed for studies matching the eligibility criteria between January 2000 and September 2022. OVID (MEDLINE), Google Scholar, EBSCOhost (EMBASE), and bibliographies of included studies were reviewed. Inclusion of studies was based on predetermined eligibility criteria. Quality appraisal and data tabulation were performed using predetermined forms. Results were synthesized by narrative review. The structure of this systematic review follows the PRISMA guidelines. This systematic review was prospectively registered in the PROSPERO register (CRD42022342144). Thirteen studies (2184 patients) were included. Within 3 months post-PTE, HRQoL improved in both CTEPD and CTEPH as measured by disease-specific and generic questionnaires. HRQoL improvements were sustained up to 5 years postoperatively in patients with CTEPH post-PTE. PTE remains the gold standard for treating CTEPH and improving HRQoL. Residual pulmonary hypertension and comorbidities such as COPD and coronary artery disease decrement HRQoL over time. The impact of mPAP and PVR on HRQoL outcomes postoperatively remain ambiguous. Pulmonary thromboendarterectomy remains the gold standard for treating CTEPH and has shown to improve HRQoL outcomes at 3-month sustaining improvements up to 5-year postoperatively. Residual pulmonary hypertension and comorbidities hinder HRQoL outcomes post-PTE.
肺动脉血栓内膜剥脱术（PTE）是目前治疗慢性血栓栓塞性肺动脉高压（CTEPH）的金标准疗法，也是治疗慢性血栓栓塞性肺疾病（CTEPD）的一种可行治疗选择。这两种疾病的进展性质在多个领域严重影响与健康相关的生活质量（HRQoL）。进行这项系统评价以评估PTE对短期和长期HRQoL的影响。在PubMed上进行文献检索，查找2000年1月至2022年9月符合纳入标准的研究。对OVID（MEDLINE）、谷歌学术、EBSCOhost（EMBASE）以及纳入研究的参考文献进行了审查。研究的纳入基于预先确定的纳入标准。使用预先确定的表格进行质量评估和数据制表。通过叙述性综述对结果进行综合。本系统评价的结构遵循PRISMA指南。本系统评价已在PROSPERO注册库（CRD42022342144）中进行了前瞻性注册。纳入了13项研究（2184例患者）。在PTE术后3个月内，通过疾病特异性和通用问卷测量，CTEPD和CTEPH患者的HRQoL均有所改善。PTE术后的CTEPH患者术后长达5年HRQoL持续改善。PTE仍然是治疗CTEPH和改善HRQoL的金标准。残余肺动脉高压以及慢性阻塞性肺疾病（COPD）和冠状动脉疾病等合并症会随着时间推移降低HRQoL。平均肺动脉压（mPAP）和肺血管阻力（PVR）对术后HRQoL结果的影响仍不明确。肺动脉血栓内膜剥脱术仍然是治疗CTEPH的金标准，并且已显示可在术后3个月改善HRQoL结果，并持续改善至术后5年。残余肺动脉高压和合并症会阻碍PTE术后的HRQoL结果。
