title: Exercise capacity affects quality of life in patients with pulmonary hypertension.
abstract: 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.
authors.affiliation: Department of Internal Medicine I, Carl Gustav Carus University Hospital, Technical University of Dresden, Fetscherstrasse 74, 01309, Dresden, Germany. michael.halank@uniklinikum-dresden.de
authors.forename: Michael
authors.initials: M
authors.lastname: Halank
authors.forename: Franziska
authors.initials: F
authors.lastname: Einsle
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lehman
authors.forename: Hinrich
authors.initials: H
authors.lastname: Bremer
authors.forename: Ralf
authors.initials: R
authors.lastname: Ewert
authors.forename: Heinrike
authors.initials: H
authors.lastname: Wilkens
authors.forename: F Joachim
authors.initials: FJ
authors.lastname: Meyer
authors.forename: Ekkehard
authors.initials: E
authors.lastname: Grünig
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Seyfarth
authors.forename: Martin
authors.initials: M
authors.lastname: Kolditz
authors.forename: Gesine
authors.initials: G
authors.lastname: Wieder
authors.forename: Gert
authors.initials: G
authors.lastname: Höffken
authors.forename: Volker
authors.initials: V
authors.lastname: Köllner
mesh_terms: D000367:Age Factors; D000368:Aged; D001007:Anxiety / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D003863:Depression / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D005080:Exercise Test; D017079:Exercise Tolerance; D065627:Familial Primary Pulmonary Hypertension; D005260:Female; D005858:Germany; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology* / Q000628:therapy; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010101:Oxygen Consumption; D010102:Oxygen Inhalation Therapy / Q000523:psychology; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires