Health-related quality of life and hospitalizations in chronic thromboembolic pulmonary hypertension versus idiopathic pulmonary arterial hypertension: an analysis from the Pulmonary Hypertension Association Registry (PHAR).

TitleHealth-related quality of life and hospitalizations in chronic thromboembolic pulmonary hypertension versus idiopathic pulmonary arterial hypertension: an analysis from the Pulmonary Hypertension Association Registry (PHAR).
Publication TypeJournal Article
Year of Publication2021
AuthorsMinhas, J, Narasimmal, SPrasanna, Bull, TM, De Marco, T, McConnell, JWesley, Lammi, MR, Thenappan, T, Feldman, JP, Sager, JS, Badesch, DB, Ryan, JJ, Grinnan, DC, Zwicke, D, Horn, EM, Elwing, JM, Moss, JE, Eggert, M, Shlobin, OA, Frantz, RP, Bartolome, SD, Mathai, SC, Mazimba, S, Pugliese, SC, Al-Naamani, N
JournalPulm Circ
Volume11
Issue4
Pagination20458940211053196
Date Published2021 Oct-Dec
ISSN2045-8932
Abstract<p>Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare, morbid, potentially curable subtype of pulmonary hypertension that negatively impacts health-related quality of life (HRQoL). Little is known about differences in HRQoL and hospitalization between CTEPH patients and idiopathic pulmonary arterial hypertension (IPAH) patients. Using multivariable linear regression and mixed effects models, we examined differences in HRQoL assessed by emPHasis-10 (E10) and SF-12 between CTEPH and IPAH patients in the Pulmonary Hypertension Association Registry, a prospective multicenter cohort of patients newly evaluated at a Pulmonary Hypertension Care Center. Multivariable negative binomial regression models were used to estimate incidence rate ratios (IRR) for hospitalization amongst the two groups. We included 461 IPAH patients and 169 CTEPH patients. Twenty-one percent of CTEPH patients underwent pulmonary thromboendarterectomy (PTE) before the end of follow-up. At baseline, patients with CTEPH had significantly worse HRQoL (higher E10 scores) (ß 2.83, SE 1.11, p = 0.01); however, differences did not persist over time. CTEPH patients had higher rates of hospitalization (excluding the hospitalization for PTE) compared to IPAH patients after adjusting for age, sex, body mass index, WHO functional class and six-minute walk distance (IRR 1.66, 95%CI 1.04-2.65, p = 0.03). CTEPH patients who underwent PTE had improved HRQoL as compared to those who were medically managed, but patients who underwent PTE were younger, had higher cardiac outputs and greater six-minute walk distances. In this large, prospective, multicenter cohort, CTEPH patients had significantly worse baseline HRQoL and higher rates of hospitalizations than those with IPAH. CTEPH patients who underwent PTE had significant improvements in HRQoL.</p>
DOI10.1177/20458940211053196
Alternate JournalPulm Circ
PubMed ID34671455
PubMed Central IDPMC8521427
Grant ListT32 HL007891 / HL / NHLBI NIH HHS / United States