Balloon pulmonary angioplasty (BPA) can improve quality of life (QoL) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) mainly by improving “usual activities,” according to study results published in the Journal of Cardiology.
The conventional treatment goal for CTEPH is improvement in hemodynamic status, particularly mean pulmonary artery pressure (mPAP). Some patients complain of impaired QoL caused by dyspnea on effort, even after their 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. Therefore, researchers aimed to quantify QoL in 45 Japanese patients with CTEPH and investigated whether BPA could improve it.
Researchers calculated QoL scores using the European Quality of Life 5 Dimension scale (EQ-5D) and found the mean QoL score in 12 of the 45 patients not involved in any therapy except supplemental oxygen at the time of initial measurement to be 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<.05; mPAP from 33.0±8.4 to 23.4±4.2 mm Hg; P <.05; pulmonary vascular resistance from 441.4±214.2 to 268.4±85.6 dyne/s/cm5; P <.05). Moreover, the index significantly correlated with mPAP (r=-0.37; P <.05), pulmonary vascular resistance (r=-0.40, P <.05), 6-minute walking distance (6MWD; r=0.45; P <.05), and percutaneous oxygen saturation at rest (SaO2; r=0.32; P <.05). Regarding individual items, median values improved only for “usual activities.”
“The Japanese EQ-5D index revealed that Japanese CTEPH patients had low QoL, particularly regarding their usual activities, but that BPA improved their EQ-5D scores,” the study authors concluded. “Moreover, there were statistically significant correlations between the EQ-5D index and mPAP, 6MWD, and SaO2 at rest.”
Minatsuki S, Kodera S, Kiyosue A, et al. Balloon pulmonary angioplasty improves quality of life in Japanese patients with chronic thromboembolic pulmonary hypertension [published online May 8, 2020]. J Cardiol. doi:10.1016/j.jjcc.2020.02.015