Abilio Reis, MD, and fellow researchers in Portugal have found that patients with pulmonary arterial hypertension (PAH) and other forms of pre-capillary pulmonary hypertension (pcPH) report poor quality of life (QoL) which is highly associated with World Health Organization (WHO) functional class, 6 minute walking distance, and Borg dyspnea indices.
Click through the slides for highlights of their study and a few clinical take home points at the end.
PAH and Quality of Life. PAH has a significant impact on patient functionality, QoL, and health related (HR) QoL Data are limited on the relationship between PAH disease severity/clinical characteristics and HRQoL impairment. Authors sought to characterize HRQoL in patients with PAH and to explore clinical correlates.
The Study. Cross-sectional, observational study looking at consecutive patients with PAH and other forms of precapillary PH; mean diseae duration was <50 mos. One general and one disease-specific quality of life questionnaire was completed by each participant.
The Results. Most patients were WHO functional class (FC) I or II (69.4%). Both CAMPHOR and NHP scores were indicative of moderate HRQoL impairment. The most common PH etiologies were chronic thromboembolic pulmonary hypertension (24.5%), congenital heart disease (22.4%), idiopathic/heritable (22.4%), connective tissue disease (14.3%), and others (16.3%). Others included PAH-associated portal hypertension (3 patients), HIV (1 patient), and group 5 PH (4 patients).
Take Home Points
Moderately impaired HRQoL is common among patients with WHO FC I and II PAH.
Greater disease severity correlates with greater levels of impairment.
HRQoL is impaired even in patients with PAH and low disease activity with associated low mortality.
Screen PAH patients for pain, low energy, sleep disturbances, social isolation, and impaired mobility and offer treatment as needed.
6-minute walking distance and Borg dyspnea indices are good tests for determining PAH severity and QoL impairment.