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Liu H, Peng W, Zhou L, Shen Y, Xu B, Xie J, Cai T, Zhou J, Li C. Depression with obstructive sleep apnea lead to high cardiovascular disease morbidity/all-cause mortality: Findings from the SHHS cohort. J Sleep Res 2023:e13828. [PMID: 36732290 DOI: 10.1111/jsr.13828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/07/2022] [Accepted: 12/28/2022] [Indexed: 02/04/2023]
Abstract
The aim of this study is to explore the association between depression and obstructive sleep apnea, and cardiovascular disease morbidity/all-cause mortality using Sleep Heart Health Study data. This post hoc analysis of a prospective study used patient data from the Sleep Heart Health Study conducted between 1995 and 1998. The association between depression and obstructive sleep apnea, and cardiovascular disease morbidity/all-cause mortality was explored using multivariable Cox proportional hazard models. A total of 4918 participants, 656 (13.3%) with obstructive sleep apnea (obstructive sleep apnea group), 1614 (32.8%) with depression (depression group), 482 (9.8%) with depression and obstructive sleep apnea (depression and obstructive sleep apnea group), and 2166 (44%) with neither obstructive sleep apnea nor depression (health group), were included. The incidence of cardiovascular disease was 24.5%, 31.0%, 31.6% and 41.7% for healthy, depression, obstructive sleep apnea, and depression and obstructive sleep apnea groups, respectively. The risk of cardiovascular disease in depression and obstructive sleep apnea participants was increased compared with that in healthy participants, which was consistent across various definitions of obstructive sleep apnea (hazard ratio [95% confidence interval]: 1.24 [1.06-1.47]; 1.25 [1.05-1.49]; 1.28 [1.06-1.54]; 1.55 [1.22-1.96] for apnea-hypopnea index ≥ 10 per hr, 15 per hr, 20 per hr, 30 per hr, respectively). The risk of all-cause mortality was increased in the depression and obstructive sleep apnea participants (hazard ratio: 1.46; 95% confidence interval: 1.07-1.99) compared with that in healthy participants when the definition of obstructive sleep apnea was apnea-hypopnea index ≥ 30. Participants with depression and obstructive sleep apnea might be at a greater risk of cardiovascular disease, and those with higher apnea-hypopnea index might be at a greater risk of all-cause mortality.
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Affiliation(s)
- Hui Liu
- Respiratory and Critical Care Department, Third Affiliated Hospital of Soochow University, First People's Hospital of Changzhou, Changzhou, China
| | - Wanda Peng
- Respiratory and Critical Care Department, Third Affiliated Hospital of Soochow University, First People's Hospital of Changzhou, Changzhou, China
| | - Lin Zhou
- Respiratory and Critical Care Department, Third Affiliated Hospital of Soochow University, First People's Hospital of Changzhou, Changzhou, China
| | - Yi Shen
- Respiratory and Critical Care Department, Third Affiliated Hospital of Soochow University, First People's Hospital of Changzhou, Changzhou, China
| | - Bin Xu
- Department of Tumor Biological Treatment, Third Affiliated Hospital of Soochow University, First People's Hospital of Changzhou, Changzhou, China
| | - Jun Xie
- Respiratory and Critical Care Department, Third Affiliated Hospital of Soochow University, First People's Hospital of Changzhou, Changzhou, China
| | - Tingting Cai
- Respiratory and Critical Care Department, Third Affiliated Hospital of Soochow University, First People's Hospital of Changzhou, Changzhou, China
| | - Jun Zhou
- Respiratory and Critical Care Department, Third Affiliated Hospital of Soochow University, First People's Hospital of Changzhou, Changzhou, China
| | - Chong Li
- Respiratory and Critical Care Department, Third Affiliated Hospital of Soochow University, First People's Hospital of Changzhou, Changzhou, China
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2
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Roy B, Vacas S, Ehlert L, McCloy K, Saggar R, Kumar R. Brain Structural Changes in Patients with Pulmonary Arterial Hypertension. J Neuroimaging 2021; 31:524-531. [PMID: 33565204 DOI: 10.1111/jon.12840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/17/2021] [Accepted: 01/20/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND PURPOSE Patients with pulmonary arterial hypertension (PAH) frequently present with anxiety, depression, autonomic, and cognitive deterioration, which may indicate brain changes in regions that control these functions. However, the precise regional brain-injury in sites that regulate cognitive, autonomic, and mood functions in PAH remains unclear. We examined the shifts in regional gray matter (GM) volume, using high-resolution T1-weighted images, and brain tissue alterations, using T2-relaxometry procedures, in PAH compared to healthy subjects. METHODS We collected two high-resolution T1-weighted series, and proton-density and T2-weighted images using a 3.0-Tesla magnetic resonance imaging scanner from 9 PAH and 19 healthy subjects. Both high-resolution T1-weighted images were realigned and averaged, partitioned to GM tissue type, normalized to a common space, and smoothed. Using proton-density and T2-weighted images, T2-relaxation maps were calculated, normalized to a common space, and smoothed. Whole-brain GM volume and T2-relaxation maps were compared between PAH and controls using analysis of covariance (covariates, age, sex, and total-brain-volume; false discover rate corrections). RESULTS Significantly decreased GM volumes, indicating tissue injury, emerged in multiple brain regions, including the hippocampus, insula, cerebellum, parahippocampus, temporal, frontal, and occipital gyri, cingulate, amygdala, and thalamus. Higher T2-relaxation values, suggesting tissue damage, appeared in the cerebellum, hippocampus, parahippocampus, frontal, lingual, and temporal and occipital gyri, and cingulate areas in PAH compared to healthy subjects. CONCLUSIONS PAH patients showed significant GM injury and brain tissue changes in sites that regulate cognition, autonomic, and mood functions. These findings indicate a brain structural basis for functional deficits in PAH patients.
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Affiliation(s)
- Bhaswati Roy
- Department of Anesthesiology, University of California Los Angeles, Los Angeles, CA
| | - Susana Vacas
- Department of Anesthesiology, University of California Los Angeles, Los Angeles, CA
| | - Luke Ehlert
- Department of Anesthesiology, University of California Los Angeles, Los Angeles, CA
| | - Kathy McCloy
- Department of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Rajan Saggar
- Department of Medicine, University of California Los Angeles, Los Angeles, CA
| | - Rajesh Kumar
- Department of Anesthesiology, University of California Los Angeles, Los Angeles, CA.,Department of Radiological Sciences, University of California Los Angeles, Los Angeles, CA.,Department of Bioengineering, University of California Los Angeles, Los Angeles, CA.,Department of Brain Research Institute, University of California Los Angeles, Los Angeles, CA
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3
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Martin V, Sarker T, Slusarek E, McCarthy MA, Granton J, Tan A, Lo C. Conversational avoidance during existential interviews with patients with progressive illness. PSYCHOL HEALTH MED 2020; 25:1073-1082. [PMID: 31975623 DOI: 10.1080/13548506.2020.1719282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We examined patterns of avoidance when existential emotional topics were raised during conversations with patients with pulmonary arterial hypertension (PAH), an incurable life-limiting disease. 30 adult outpatients with PAH were recruited for a 20 to 60-minute interview about their illness experience. Qualitative content analysis was used to identify avoidance strategies that patients employed. Participants averaged 58 years in age (SD = 18), 77% were female, and mean length of illness was 6.3 years (SD = 5.3). We found four avoidance strategies: (1) Reversal, when individuals would begin discussing a negative concern and then backtrack to more positive sentiments; (2) Diversion for when patients would sidetrack the conversation to a different and less uncomfortable topic; (3) Diminishment for when a concern is raised and then made to seem unimportant; and (4) Obstruction, when patients refuse to discuss a concern further. Exploration of existential concerns can elicit distress but may be necessary to promote adaptation to progressive illness and to the foreseeable challenges that may affect the sense of life meaning and value. By recognizing when existential concerns may be present but not adequately discussed, clinicians may be better able to assist patients to cope and prepare for the future.
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Affiliation(s)
- Vanessa Martin
- Department of Psychology, Queen's University , Kingston, Canada.,Department of Psychology, University of Guelph-Humber , Etobicoke, Canada
| | - Tasmie Sarker
- Department of Psychology, University of Guelph-Humber , Etobicoke, Canada
| | - Emily Slusarek
- Department of Biology, Trent University , Peterborough, Canada
| | - Mary A McCarthy
- Pulmonary Hypertension Program, Toronto General Hospital, University Health Network , Toronto, Canada
| | - John Granton
- Pulmonary Hypertension Program, Toronto General Hospital, University Health Network , Toronto, Canada.,Department of Medicine, Faculty of Medicine, University of Toronto , Toronto, Canada
| | - Adrienne Tan
- Pulmonary Hypertension Program, Toronto General Hospital, University Health Network , Toronto, Canada.,Department of Psychiatry, University of Toronto , Toronto, Canada
| | - Christopher Lo
- Department of Psychiatry, University of Toronto , Toronto, Canada.,Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto , Toronto, Canada
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Abstract
Patients with comorbidities are often excluded from clinical trials, limiting the evidence base for pulmonary arterial hypertension (PAH)-specific therapies. This review aims to discuss the effect of comorbidities on the diagnosis and management of PAH. The comorbidities discussed in this review (systemic hypertension, obesity, sleep apnoea, clinical depression, obstructive airway disease, thyroid disease, diabetes, and ischaemic cardiovascular event) were chosen based on their prevalence in patients with idiopathic PAH in the REVEAL registry (Registry to EValuate Early and Long-term PAH disease management). Comorbidities can mask the symptoms of PAH, leading to delays in diagnosis and also difficulty evaluating disease progression and treatment effects. Due to the multifactorial pathophysiology of pulmonary hypertension (PH), the presence of comorbidities can lead to difficulties in distinguishing between Group 1 PH (PAH) and the other group classifications of PH. Many comorbidities contribute to the progression of PAH through increased pulmonary artery pressures and cardiac output, therefore treatment of the comorbidity may also reduce the severity of PAH. Similarly, the development of one comorbidity can be a risk factor for the development of other comorbidities. The management of comorbidities requires consideration of drug interactions, polypharmacy, adherence and evidence-based strategies. A multidisciplinary team should be involved in the management of patients with PAH and comorbidities, with appropriate referral to supportive services when necessary. The treatment goals and expectations of patients must be managed in the context of comorbidities.
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Affiliation(s)
- Irene M Lang
- Department of Internal Medicine II, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Massimiliano Palazzini
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via Zamboni, 33 - 40126 Bologna, Italy
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Karapolat H, Çınar ME, Tanıgör G, Nalbantgil S, Kayıkçıoğlu M, Moğulkoç N, Kültürsay H. Effects of cardiopulmonary rehabilitation on pulmonary arterial hypertension: A prospective, randomized study. Turk J Phys Med Rehabil 2019; 65:278-86. [PMID: 31663077 DOI: 10.5606/tftrd.2019.2758] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 06/12/2018] [Indexed: 01/28/2023] Open
Abstract
Objectives This study aims to investigate the effects of cardiopulmonary rehabilitation (CPR) on cardiopulmonary function, quality of life, depression, and hemodynamic parameters in patients with pulmonary arterial hypertension (PAH) and to compare the efficacy of hospital- and home-based exercise programs. Patients and methods Between December 2014 to May 2016, a total of 30 patients with PAH were included in the study. The patients were randomly assigned to either a hospital-based (n=15) or home-based exercise program (n=15). The hospital group was assigned to a cardiac rehabilitation (three days/week, 1 hour/week 50 to 70% maximal oxygen uptake [PvO2]) program for eight weeks. The home-based exercise group received home exercises alone. Before and after eight weeks of rehabilitation, all patients were evaluated for their functional status (PvO2), pulmonary function including forced expiratory volume in one sec (FEV1), mL, forced vital capacity (FVC), mL and FEV1/FVC%, quality of life using Short Form-36 (SF-36), depression severity using Beck Depression Inventory, and hemodynamic parameters including left ventricular ejection fraction, right ventricular ejection fraction, left ventricular end-systolic diameter, left ventricular end-diastolic diameter, and systolic pulmonary arterial pressure. Results Of the patients, 12 completed the study in each group. There was no statistically significant difference in the functional status, quality of life, depression severity, and hemodynamic parameters after the rehabilitation compared baseline between the groups. Conclusion Based on our study results, short-term CPR seems not to be beneficial in patients with PAH. We recommend long-term rehabilitation programs to achieve more benefits from aerobic exercise training in this patient population.
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Lo C, Sarker T, Canning O, Martin V, McCarthy MA, Granton J, Tan A. Clinical presentation of existential distress in pulmonary arterial hypertension. Canadian Journal of Respiratory, Critical Care, and Sleep Medicine 2018. [DOI: 10.1080/24745332.2018.1507614] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Chris Lo
- Psychology, University of Guelph-Humber, Toronto, Canada
- Psychiatry, University of Toronto, Toronto, Canada
- Institute for Life Course and Aging, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
- Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
- Social and Behavioural Health Sciences Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Tasmie Sarker
- Psychology, University of Guelph-Humber, Toronto, Canada
- Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Orla Canning
- Psychology, University of Guelph-Humber, Toronto, Canada
- Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Vanessa Martin
- Psychology, University of Guelph-Humber, Toronto, Canada
- Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Mary A. McCarthy
- Pulmonary Hypertension Program, Toronto General Hospital, University Health Network, Toronto, Canada
| | - John Granton
- Pulmonary Hypertension Program, Toronto General Hospital, University Health Network, Toronto, Canada
| | - Adrienne Tan
- Psychiatry, University of Toronto, Toronto, Canada
- Pulmonary Hypertension Program, Toronto General Hospital, University Health Network, Toronto, Canada
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7
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Yorke J, Deaton C, Campbell M, McGowen L, Sephton P, Kiely DG, Armstrong I. Symptom severity and its effect on health-related quality of life over time in patients with pulmonary hypertension: a multisite longitudinal cohort study. BMJ Open Respir Res 2018. [PMID: 29531745 PMCID: PMC5844371 DOI: 10.1136/bmjresp-2017-000263] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Introduction The aim of this cohort study was to examine health-related quality of life (HRQoL) and symptomatology in patients with pulmonary hypertension (PH) and explore factors that influence its evolution over time. Methods A prospective longitudinal multisite cohort study. Participants were recruited from specialist UK PH centres and completed a questionnaire pack at baseline, 6, 12 and 18 months to assess HRQoL (emPHasis-10), dyspnoea, fatigue, sleep, anxiety and depression. Results 185 patients entered the study at baseline and 126 (68%) completed month 18. At baseline, patients had significant impairment of HRQoL, anxiety, depression, dyspnoea and severe fatigue. No significant changes, apart from a reduction in the Hospital Anxiety and Depression Scale-Anxiety score (P=0.04), were observed over 18 months. Depression and dyspnoea were predictors of HRQoL (P=0.002 and P=0.03, respectively). Oxygen use was also associated with diminished HRQoL and increased symptom severity. Conclusion Patients with PH experience high levels of symptom severity and the negative impact on HRQoL was unchanged over time. The use of oxygen therapy, in particular, was associated with a significant impact on HRQoL. Further study of factors impacting HRQoL and interventions that target a combination of physiological and psychosocial consequences of living with PH are needed.
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Affiliation(s)
- Janelle Yorke
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | - Christi Deaton
- Cambridge Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Malcolm Campbell
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester, Manchester, UK
| | - Linda McGowen
- School of Healthcare, University of Leeds, Leeds, UK
| | - Paul Sephton
- Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, UK
| | - David G Kiely
- Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, UK.,Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Iain Armstrong
- Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, UK
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8
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Abstract
Idiopathic pulmonary fibrosis (IPF) is a devastating, progressive and ultimately fatal lung disease. The combination of poor prognosis, uncertainty of disease course and severe symptom burden heavily impacts patients' and their families' quality of life. Though new antifibrotic drugs have been shown to decrease disease progression, the effect on health-related quality of life (HRQOL) has not been convincingly demonstrated. In a relentless disease such as IPF, striving to optimize HRQOL should complement the endeavour to prolong life. Unfortunately, there is a paucity of interventions improving symptoms and functionality for patients with IPF, and research focusing on symptom improvement, and assessing and optimizing HRQOL, is limited. This review summarizes the most recent insights into measuring and improving quality of life for patients with IPF, and discusses challenges in the management of this devastating disease. Moreover, we postulate a new model for continuous care in IPF - 'the ABCDE of IPF care': Assessing patients' needs; Backing patients by giving information and support; delivering Comfort care by focusing on treating symptoms and taking into account Comorbidities; striving to prolong life by Disease modification; helping and preparing patients and their caregivers for the eventual End-of-life events that are likely to occur.
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Affiliation(s)
- Mirjam J G van Manen
- Department of Respiratory Medicine, Erasmus Medical Center, University Hospital Rotterdam, The Netherlands
| | - J J Miranda Geelhoed
- Department of Respiratory Medicine, Erasmus Medical Center, University Hospital Rotterdam, The Netherlands
| | - Nelleke C Tak
- Department of Respiratory Medicine, Erasmus Medical Center, University Hospital Rotterdam, The Netherlands
| | - Marlies S Wijsenbeek
- Department of Respiratory Medicine, Erasmus Medical Center, University Hospital Rotterdam, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
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Abstract
Pulmonary arterial hypertension (PAH) is a debilitating condition leading to progressive decline in functional capacity. As a result, PAH can lead to psychological impairment that can impact the overall disease status. The medical community has developed several screening questionnaires in order to assess depression in their patients allowing physicians to be at the forefront of recognizing clinical depression. There is a suggestion that depression symptomatology is more prevalent in the PAH population. The aim of this article is to review the current thought process about diagnosis and management of depression in PAH patients.
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Affiliation(s)
- Sameer Verma
- Department of Pulmonary, Critical Care and Sleep Medicine, North Shore - Long Island Jewish Health System, New York, USA
| | - Sonu Sahni
- Department of Pulmonary, Critical Care and Sleep Medicine, North Shore - Long Island Jewish Health System, New York, USA
| | - Vannan K Vijayan
- Department of Medicine and Chest Diseases, Clinical Support Services, Baby Memorial Hospital, Kozhikode, Kerala, India
| | - Arunabh Talwar
- Department of Pulmonary, Critical Care and Sleep Medicine, North Shore - Long Island Jewish Health System, New York, USA
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Talwar A, Sahni S, Kim EJ, Verma S, Kohn N. Dyspnea, depression and health related quality of life in pulmonary arterial hypertension patients. J Exerc Rehabil 2015; 11:259-65. [PMID: 26535216 PMCID: PMC4625654 DOI: 10.12965/jer.150230] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 10/01/2015] [Indexed: 01/22/2023] Open
Abstract
Pulmonary arterial hypertension (PAH) is a rare and devastating disease which is characterized by worsening dyspnea and exercise tolerance. These patients are often found to have concomitant, depression, anxiety and impaired health-related quality of life (HRQOL). The interrelationship of dyspnea, depression and HRQOL in these patients is not well studied. Retrospective analysis was performed on 46 PAH patients (mean age 51.73). Patients completed Medical Outcomes Study Short - Form 36 V2 (SF-36) to measure HRQOL, Modified Medical Research Council (mMRC) Dyspnea Scale and Zung Depression Scale (ZDS). Physical Health Composite Scores (PCS) and Mental Health Composite Scores (MCS) were derived from SF-36. Spearman’s correlation was computed to determine degree of correlation between pairs of scales. 46 patients (12 males, 34 females; median age 51.4 yr) with confirmed PAH were considered for the study of which 36 patients (9 males, 27 females, median age 50.1 yr), were eligible for further analysis. MMRC Dyspnea Scale Score was 1.0 (Q1 to Q3:1.0 to 2.0). Median MCS was 52.1 (Q1 to Q3:41.7 to 57.1) and PCS was 37.9 (Q1 to Q3: 30.7 to 49.6). There was a significant negative correlation between dyspnea and PCS (r =−0.660, P<0.0001) and MCS (r =−0.342, P<0.0411). The ZDS was available for 17 of these patients; their median score was 42.0 (Q1 to Q3: 33.0 to 46.0). There was a significant correlation between the ZDS and PCS (r =−0.578, P<0.0150,) MCS (r =−0.752, P<0.0005). Patients with PAH suffer from diminished HRQOL correlating with their dyspnea and underlying depression.
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Affiliation(s)
- Arunabh Talwar
- North Shore-Long Island Jewish Health System, Department of Pulmonary, Critical Care and Sleep Medicine, New Hyde Park, NY, USA ; Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Sonu Sahni
- North Shore-Long Island Jewish Health System, Department of Pulmonary, Critical Care and Sleep Medicine, New Hyde Park, NY, USA ; Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Eun Ji Kim
- North Shore-Long Island Jewish Health System, Department of Medicine, Manhasset, NY, USA
| | - Sameer Verma
- North Shore-Long Island Jewish Health System, Department of Pulmonary, Critical Care and Sleep Medicine, New Hyde Park, NY, USA ; Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Nina Kohn
- Feinstein Institute for Medical Research, Manhasset, NY, USA
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11
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Sahni S, Capozzi B, Iftikhar A, Sgouras V, Ojrzanowski M, Talwar A. Pulmonary rehabilitation and exercise in pulmonary arterial hypertension: An underutilized intervention. J Exerc Rehabil 2015; 11:74-9. [PMID: 25960979 PMCID: PMC4415753 DOI: 10.12965/jer.150190] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Accepted: 04/08/2015] [Indexed: 01/01/2023] Open
Abstract
Pulmonary arterial hypertension (PAH) is a rare and devastating disease characterized by progressive increases in pulmonary arterial pressure and pulmonary vascular resistance which eventually leads to right ventricular failure and death. Early thought process was that exercise and increased physical activity may be detrimental to PAH patients however many small cohort trials have proven otherwise. In addition to the many pharmaceutical options, exercise and pulmonary rehabilitation have also been shown to increase exercise capacity as well as various aspects of psychosomatic health. As pulmonary and exercise rehabilitation become more widely used as an adjuvant therapy patient outcomes improve and physicians should consider this in the therapeutic algorithm along with pharmacotherapy.
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Affiliation(s)
- Sonu Sahni
- North Shore - Long Island Jewish Health System, Department of Pulmonary, Critical Care and Sleep Medicine, New Hyde Park, NY, USA
| | - Barbara Capozzi
- Touro College of Osteopathic Medicine, Department of Primary Care, New York, NY, USA
| | - Asma Iftikhar
- North Shore - Long Island Jewish Health System, Department of Pulmonary, Critical Care and Sleep Medicine, New Hyde Park, NY, USA
| | - Vasiliki Sgouras
- Seton Hall University - School of Health and Medical Sciences, South Orange, NJ, USA
| | | | - Arunabh Talwar
- North Shore - Long Island Jewish Health System, Department of Pulmonary, Critical Care and Sleep Medicine, New Hyde Park, NY, USA ; Hofstra North Shore - LIJ School of Medicine, Hofstra University, Hempstead, NY, USA
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