Mitsuyama Yuzuki, Goda Ayumi, Takeuchi Kaori, Kikuchi Hanako, Inami Takumi, Soejima Kyoko, Kohno Takashi
Faculty of Medicine, Kyorin University Tokyo Japan.
Department of Cardiovascular Medicine, Kyorin University Tokyo Japan.
Circ Rep. 2025 Feb 22;7(4):285-292. doi: 10.1253/circrep.CR-24-0113. eCollection 2025 Apr 10.
Depression and anxiety screening has not been adequately examined in patients with pulmonary hypertension (PH). We assessed depression and anxiety prevalence and their determinants in pulmonary arterial hypertension (PAH) and chronic thromboembolic PH (CTEPH).
This cross-sectional study included 234 patients with PH (age 57 [42-68] years; 75% female; PAH/CTEPH/other: 103/126/5). Overall, 24% and 26% of patients had depression (Hospital Anxiety and Depression Scale [HADS]-depression score ≥8) and anxiety (HADS-anxiety score ≥8) respectively. Depression and anxiety prevalence was 18% and 19% in PAH and 27% and 30% in CTEPH, respectively. Among patients with PAH, depression was significantly associated with higher mean right atrial pressure (odds ratio [OR] 1.17; 95% confidence interval [CI] 1.03-1.32; P=0.013), higher pulmonary vascular resistance (OR 1.08; 95% CI 1.01-1.16; P=0.034), lower arterial oxygen saturation (OR 0.89; 95% CI 0.80-0.98; P=0.021), pulmonary artery oxygen saturation (OR 0.93; 95% CI 0.87-0.99; P=0.020), and reduced use of phosphodiesterase-5 inhibitor (OR 0.30; 95% CI 0.11-0.86; P=0.025). In CTEPH, depression was significantly associated with the presence of a psychiatric disorder (OR 4.71; 95% CI 1.24-17.90; P=0.023). Anxiety was not significantly associated with any of the aforementioned parameters in PAH and CTEPH.
Predicting depression and anxiety based on disease severity and hemodynamics was challenging, making individual assessments and approaches crucial.
肺动脉高压（PH）患者的抑郁和焦虑筛查尚未得到充分研究。我们评估了肺动脉高压（PAH）和慢性血栓栓塞性肺动脉高压（CTEPH）患者的抑郁和焦虑患病率及其决定因素。
这项横断面研究纳入了234例PH患者（年龄57[42 - 68]岁；75%为女性；PAH/CTEPH/其他类型：103/126/5）。总体而言，分别有24%和26%的患者存在抑郁（医院焦虑抑郁量表[HADS]-抑郁评分≥8）和焦虑（HADS-焦虑评分≥8）。PAH患者中抑郁和焦虑的患病率分别为18%和19%，CTEPH患者中分别为27%和30%。在PAH患者中，抑郁与较高的平均右心房压显著相关（比值比[OR]1.17；95%置信区间[CI]1.03 - 1.32；P = 0.013）、较高的肺血管阻力（OR 1.08；95% CI 1.01 - 1.16；P = 0.034）、较低的动脉血氧饱和度（OR 0.89；95% CI 0.80 - 0.98；P = 0.021）、肺动脉血氧饱和度（OR 0.93；95% CI 0.87 - 0.99；P = 0.020）以及磷酸二酯酶-5抑制剂使用减少（OR 0.30；95% CI 0.11 - 0.86；P = 0.025）。在CTEPH患者中，抑郁与精神疾病的存在显著相关（OR 4.71；95% CI 1.24 - 17.90；P = 0.023）。在PAH和CTEPH患者中，焦虑与上述任何参数均无显著相关性。
基于疾病严重程度和血流动力学预测抑郁和焦虑具有挑战性，因此个体评估和方法至关重要。
