Quality of life as a prognostic marker in pulmonary arterial hypertension

Quality of life as a prognostic marker in pulmonary arterial hypertension

Author Fernandes, Caio J. C. S. Google Scholar
Martins, Barbara C. S. Google Scholar
Jardim, Carlos V. P. Google Scholar
Ciconelli, Rozana M. Autor UNIFESP Google Scholar
Morinaga, Luciana K. Google Scholar
Breda, Ana Paula Google Scholar
Hoette, Susana Google Scholar
Souza, Rogerio Google Scholar
Institution Universidade de São Paulo (USP)
Universidade Federal de São Paulo (UNIFESP)
Abstract Background: Improvement in quality of life together with better survival are the ultimate goals in the treatment of pulmonary arterial hypertension (PAH) patients. the objective of this study was to evaluate the health-related quality of life (HRQL) of pulmonary arterial hypertension (PAH) patients with the SF-36 generic questionnaire and to identify the prognostic implication of this assessment.Methods: Fifty-four consecutive newly diagnosed PAH patients (WHO classification group I) in a single PAH reference center were included. Patients were evaluated at baseline for clinical and hemodynamic parameters, and they subsequently received first-line therapy with either an endothelin receptor antagonist or a phosphodiesterase-5 inhibitor. After 16 weeks of specific PAH therapy, all patients were re-evaluated using a 6MWT and a SF 36 questionnaire, and then they were followed up for at least 36 months.Results: After treatment, the patients demonstrated an improved 6MWT (414 +/- 124 m vs. 440 +/- 113 m, p = 0.001). Specific PAH therapy also improved the HRQL scores.Patients with a baseline Physical Component Score (PCS) higher than 32 had a better survival rate than those who had a score under 32 (p = 0.04). Similarly, patients with a PCS of at least a 38 after the 16 week therapy period had a better survival rate when compared with those who did not achieve this value (p = 0.016). Unlike the absolute PCS values, the post-treatment PCS variability was unable to predict better survival rates (p = 0.58).Conclusions: Our findings suggest that HRQL is associated with prognosis in PAH. Furthermore, achieving pre-determined PCS scores might represent a specific goal to be reached in treatment-to-target strategies.
Keywords Quality of life
Pulmonary arterial hypertension
Survival
Prognosis
Treatment
Language English
Date 2014-08-30
Published in Health and Quality of Life Outcomes. London: Biomed Central Ltd, v. 12, 6 p., 2014.
ISSN 1477-7525 (Sherpa/Romeo, impact factor)
Publisher Biomed Central Ltd
Extent 6
Origin http://dx.doi.org/10.1186/s12955-014-0130-3
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000342017900001
URI http://repositorio.unifesp.br/handle/11600/38109

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