Shun Minatsuki1, Satoshi Kodera2, Arihiro Kiyosue2, Akihito Saito2, Hisataka Maki2, Masaru Hatano3, Eiki Takimoto2, Issei Komuro2. 1. Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. Electronic address: shunminatsuki-tky@umin.ac.jp. 2. Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 3. Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Abstract
BACKGROUND: The conventional treatment goal for chronic thromboembolic pulmonary hypertension (CTEPH) is improving hemodynamic status, particularly mean pulmonary artery pressure (mPAP); however, some patients complain of impaired quality of life (QOL) caused by dyspnea on effort, even after hemodynamic status has fully improved. It remains unclear whether treatment for CTEPH can improve patients' QOL or whether quantitative measures of QOL correlate with hemodynamic status. This study quantified QOL among Japanese CTEPH patients and investigated whether balloon pulmonary angioplasty (BPA) improved QOL. METHODS AND RESULTS: We calculated the QOL scores of 45 CTEPH patients using the European Quality of Life Five Dimension scale (EQ-5D). The mean QOL score among 12 of those 45 not involved in any therapy except supplemental oxygen at the time of initial measurement was 0.673 ± 0.251. QOL was measured before and after BPA for 17 patients, and the mean significantly improved (QOL from 0.741 ± 0.195 to 0.802 ± 0.160, p < 0.05; mPAP from 33.0 ± 8.4 to 23.4 ± 4.2 mmHg, p < 0.05; pulmonary vascular resistance from 441.4 ± 214.2 to 268.4 ± 85.6 dyne/s/cm5, p < 0.05). Moreover, the index significantly correlated with mPAP (r = -0.37, p < 0.05), pulmonary vascular resistance (r = -0.40, p < 0.05), 6-min walking distance (r = 0.45, p < 0.05), and percutaneous oxygen saturation at rest (r = 0.32, p < 0.05). Regarding individual items, median values improved only regarding "usual activities." Our findings prove that BPA improved QOL measured by the EQ-5D in Japanese CTEPH patients by improving "usual activities" scores. CONCLUSION: BPA improved QOL in patients with CTEPH mainly by improving "usual activities," besides the improvement in mPAP.
BACKGROUND: The conventional treatment goal for chronic thromboembolic pulmonary hypertension (CTEPH) is improving hemodynamic status, particularly mean pulmonary artery pressure (mPAP); however, some patients complain of impaired quality of life (QOL) caused by dyspnea on effort, even after hemodynamic status has fully improved. It remains unclear whether treatment for CTEPH can improve patients' QOL or whether quantitative measures of QOL correlate with hemodynamic status. This study quantified QOL among Japanese CTEPHpatients and investigated whether balloon pulmonary angioplasty (BPA) improved QOL. METHODS AND RESULTS: We calculated the QOL scores of 45 CTEPHpatients using the European Quality of Life Five Dimension scale (EQ-5D). The mean QOL score among 12 of those 45 not involved in any therapy except supplemental oxygen at the time of initial measurement was 0.673 ± 0.251. QOL was measured before and after BPA for 17 patients, and the mean significantly improved (QOL from 0.741 ± 0.195 to 0.802 ± 0.160, p < 0.05; mPAP from 33.0 ± 8.4 to 23.4 ± 4.2 mmHg, p < 0.05; pulmonary vascular resistance from 441.4 ± 214.2 to 268.4 ± 85.6 dyne/s/cm5, p < 0.05). Moreover, the index significantly correlated with mPAP (r = -0.37, p < 0.05), pulmonary vascular resistance (r = -0.40, p < 0.05), 6-min walking distance (r = 0.45, p < 0.05), and percutaneous oxygen saturation at rest (r = 0.32, p < 0.05). Regarding individual items, median values improved only regarding "usual activities." Our findings prove that BPA improved QOL measured by the EQ-5D in Japanese CTEPHpatients by improving "usual activities" scores. CONCLUSION:BPA improved QOL in patients with CTEPH mainly by improving "usual activities," besides the improvement in mPAP.