Effects of Surgical and Medical Treatment on Quality of Life for Patients With Chronic Thromboembolic Pulmonary Hypertension

Takashi Urushibara; Nobuhiro Tanabe; Rika Suda; Fumiaki Kato; Hajime Kasai; Takao Takeuchi; Ayumi Sekine; Rintaro Nishimura; Takayuki Jujo; Toshihiko Sugiura; Ayako Shigeta; Seiichiro Sakao; Yasunori Kasahara; Koichiro Tatsumi

doi:10.1253/circj.CJ-15-0538

Pulmonary Circulation

Effects of Surgical and Medical Treatment on Quality of Life for Patients With Chronic Thromboembolic Pulmonary Hypertension

Takashi Urushibara, Nobuhiro Tanabe, Rika Suda, Fumiaki Kato, Hajime Kasai, Takao Takeuchi, Ayumi Sekine, Rintaro Nishimura, Takayuki Jujo, Toshihiko Sugiura, Ayako Shigeta, Seiichiro Sakao, Yasunori Kasahara, Koichiro Tatsumi

Author information

Takashi Urushibara
Department of Respirology, Graduate School of Medicine, Chiba University
Nobuhiro Tanabe
Department of Respirology, Graduate School of Medicine, Chiba University
Department of Advanced Medicine in Pulmonary Hypertension, Graduate School of Medicine, Chiba University
Rika Suda
Department of Respirology, Graduate School of Medicine, Chiba University
Fumiaki Kato
Department of Respirology, Graduate School of Medicine, Chiba University
Hajime Kasai
Department of Respirology, Graduate School of Medicine, Chiba University
Takao Takeuchi
Department of Respirology, Graduate School of Medicine, Chiba University
Ayumi Sekine
Department of Respirology, Graduate School of Medicine, Chiba University
Rintaro Nishimura
Department of Respirology, Graduate School of Medicine, Chiba University
Takayuki Jujo
Department of Respirology, Graduate School of Medicine, Chiba University
Department of Advanced Medicine in Pulmonary Hypertension, Graduate School of Medicine, Chiba University
Toshihiko Sugiura
Department of Respirology, Graduate School of Medicine, Chiba University
Ayako Shigeta
Department of Respirology, Graduate School of Medicine, Chiba University
Department of Advanced Medicine in Pulmonary Hypertension, Graduate School of Medicine, Chiba University
Seiichiro Sakao
Department of Respirology, Graduate School of Medicine, Chiba University
Yasunori Kasahara
Department of Respirology, Graduate School of Medicine, Chiba University
Koichiro Tatsumi
Department of Respirology, Graduate School of Medicine, Chiba University

Keywords: Chronic thromboembolic pulmonary hypertension, Pulmonary endarterectomy, Pulmonary vasodilator, Quality of life

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Supplementary material

2015 Volume 79 Issue 12 Pages 2696-2702

DOI https://doi.org/10.1253/circj.CJ-15-0538

Editorial (79-12 pp.2553-2554)

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Abstract

Background:This study aimed to investigate the predictors of quality of life (QOL) in patients with chronic thromboembolic pulmonary hypertension (CTEPH), changes in QOL after surgical and medical treatments, and the relationship between baseline QOL and survival.Methods and Results:QOL was measured in 128 patients with CTEPH (male/female: 42/86, age: 56±12 years, surgical/medical: 65/63) using the Short-Form 36 (SF-36) questionnaire. Multiple regression analysis showed pulmonary vascular resistance (PVR) and 6-min walking distance (6MWD) were associated with physical functioning (PF) (P<0.01) and physical component summary (PCS) (P<0.01). In the surgical group, 7 subscales and 2 summary scores improved significantly, and in the medical group 6 subscales and the mental component summary, although the change in QOL was greater in the surgical group. The patients in the conventional therapy group with higher PF had significantly better survival than those with lower PF (5-years survival: 89.5% vs. 50.8%, P=0.002). This difference in survival was not observed in the group receiving pulmonary arterial hypertension (PAH)-specific therapy (100% vs. 100%, P=0.746).Conclusions:PVR and 6MWD were associated with PF or PCS in CTEPH patients. QOL improved after surgical or medical therapy, with a greater change in the surgical group. PAH-specific therapy improved survival in patients with lower PF at diagnosis. (Circ J 2015; 79: 2696–2702)

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