Pulmonary Vascular Disease |

Dyspnea, Depression, and Health Related Quality of Life [HRQOL] in Patients With Pulmonary Artery Hypertension [PAH] FREE TO VIEW

Eun Ji Kim, MD; Sameer Verma, BS; Sonu Sahni, BS; Katherine Athaanasiou, BS; Purvesh Patel, MD; Nina Kohn, MBA; Arunabh Talwar, MD
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North Shore - LIJ Health System, New Hyde Park, NY

Chest. 2013;144(4_MeetingAbstracts):864A. doi:10.1378/chest.1703225
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SESSION TITLE: DVT/PE/Pulmonary Hypertension Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: Aim of this study was to determine the relationship between HRQOL, self reported dyspnea and depression in patients with pulmonary arterial hypertension.

METHODS: 64 patients were enrolled in the study. 45 patients [11 males, 34 females; mean age 51.3 years] with WHO Group I (PAH) and 19 patients [9 males, 10 females; mean age 69.8 years] with WHO Group III. Patients completed Medical Outcomes Study Short - Form 36 V2 to measure generic HRQOL, Modified Medical Research Council [mMRC] Dyspnea Scale and Zung Depression scale. Physical Health Composite Scores [PCS] and Mental Health Composite Scores [MCS] were derived from SF36V2. For each scale, Mann-Whitney test was used to examine the association between WHO Groups (Group I or Group III) and that scale. The Spearman's correlation coefficient was computed to determine the degree of correlation between each pair of scales. Summary statistics are reported as medians and 25th percentile (Q1) to 75th percentile (Q3).

RESULTS: Dyspnea was significantly higher in WHO Group III (p<0.0036) [Median dyspnea in Group III was 2.0 (Q1 to Q3: 1.0 to 4.0) whereas median dyspnea in Group I was 1.0 (Q1 to Q3: 1.0 to 2.0)]. MCS (SF36) was significantly lower in Group III patients (p<0.0085) [Median MCS in Group III was 35.3 (Q1 to Q3: 28.5 to 48.7) and in Group I was 51.5 (Q1 to Q3: 38.6 to 57.2)]. In PAH patients there was a significant correlation between dyspnea and PCS (r = -0.660, p<0.0001, n=36) and between dyspnea and MCS (r = -0.342, p<0.0411, n=36). There was also a significant correlation between the Zung depression scale and PCS (r = -0.578, p<0.0150, n=17) and between Zung depression scale and MCS (r=-0.752, p<0.0005, n=17).

CONCLUSIONS: Patients with PAH suffer from diminished HRQOL which correlates with their dyspnea and underlying depression. Healthcare providers need to appreciate the psychosocial impairment of patients with PAH. Cognitive behavioral interventions may benefit these patients.

CLINICAL IMPLICATIONS: Further studies are necessary to evaluate and design interventions to improve HRQOL in these patients.

DISCLOSURE: The following authors have nothing to disclose: Eun Ji Kim, Sameer Verma, Sonu Sahni, Katherine Athaanasiou, Purvesh Patel, Nina Kohn, Arunabh Talwar

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