EmPHasis-10 Health-Related Quality of Life and Exercise Capacity in Chronic Thromboembolic Pulmonary Hypertension After Balloon Angioplasty: A Cross-Sectional Study

Abstract

Background Whether pulmonary haemodynamic parameters and functional capacity are associated with quality of life (QoL) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) remains unknown. This study aimed to evaluate disease-specific QoL with the emPHasis-10 questionnaire and assess its determinants in CTEPH patients with normalised pulmonary haemodynamics. Methods This cross-sectional study included 143 patients with CTEPH (median age, 68 [58–75] years; men/women, 51/136; use of home oxygen therapy [HOT], 51 patients [27%]) after balloon pulmonary angioplasty (BPA) with normalised mean pulmonary artery pressure (PAP) <25 mmHg at rest. Right heart catheterisation was performed, followed by the 6-minute walk test (6MWD) and the emPHasis-10 questionnaire. Results The median PAP and pulmonary vascular resistance were 18 (15–21) mmHg and 2.2 (1.7–2.9) Wood units, respectively. The median emPHasis-10 score was 14 (range, 8–24), whereas the median 6MWD was 447 (385–517) m. Univariate linear regression analysis showed that the emPHasis-10 score was associated with 6MWD (β = -0.476 [95% CI -0.604, -0.348], p < 0.001) and HOT (β = 0.214 [95% CI 0.072, 0.356], p = 0.003), but not with haemodynamic parameters. Multiple regression analysis revealed that a higher emPHasis-10 score was associated with lower 6MWD (β = -0.475 [95% CI -0.631, -0.319], p < 0.001). Conclusion Health-related QoL was associated with exercise capacity and the use of HOT, but not haemodynamic parameters, in patients with CTEPH after BPA with normalised haemodynamics. Improvements in exercise capacity may lead to further improvements in QoL.