Exercise capacity affects quality of life in patients with pulmonary hypertension

Lung. 2013 Aug;191(4):337-43. doi: 10.1007/s00408-013-9472-6. Epub 2013 May 17.


Background: The objective of this prospective study was to evaluate the impact of exercise capacity, mental disorders, and hemodynamics on quality-of-life (QoL) parameters in patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH).

Methods: Sixty-three patients with invasively diagnosed PAH (n = 48) or CTEPH (n = 15) underwent a broad panel of assessments, including cardiopulmonary exercise testing (CPET), 6-minute walking distance (6-MWD), World Health Organization functional class (WHO-FC), and assessment of hemodynamics. QoL was evaluated by the 36-item Medical Outcome Study Short Form Health Survey Questionnaire (SF-36). Exercise capacity, hemodynamics, age, gender, and mental disorders (anxiety and depression) were assessed for association with QoL subscores by uni- and multivariate regression analyses.

Results: Exercise capacity, WHO-FC, oxygen therapy, symptoms of right heart failure, right atrial pressure, and mental disorders were significantly associated with QoL (p < 0.05). In the stepwise backward selection multivariate analysis, depression remained an independent parameter in seven of eight subscales of the SF-36. Furthermore, peak oxygen uptake (peakVO2) during CPET, 6-MWD, anxiety, long-term oxygen therapy, right heart failure, and age remained independent factors for QoL. Hemodynamic parameters at rest did not independently correlate with any domain of the SF-36 QoL subscores.

Conclusions: Mental disorders, exercise capacity, long-term oxygen therapy, right heart failure, and age play important role in the quality of life in patients with PAH and CTEPH.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Anxiety / complications
  • Anxiety / diagnosis
  • Anxiety / psychology
  • Depression / complications
  • Depression / diagnosis
  • Depression / psychology
  • Exercise Test
  • Exercise Tolerance*
  • Familial Primary Pulmonary Hypertension
  • Female
  • Germany
  • Heart Failure / etiology
  • Heart Failure / physiopathology
  • Heart Failure / psychology
  • Hemodynamics
  • Humans
  • Hypertension, Pulmonary / complications
  • Hypertension, Pulmonary / diagnosis
  • Hypertension, Pulmonary / physiopathology*
  • Hypertension, Pulmonary / psychology*
  • Hypertension, Pulmonary / therapy
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Oxygen Consumption
  • Oxygen Inhalation Therapy / psychology
  • Prognosis
  • Prospective Studies
  • Quality of Life*
  • Risk Factors
  • Surveys and Questionnaires