Clinical characteristics and prognosis in patients with chronic thromboembolic pulmonary hypertension and a concomitant psychiatric disorder. (March 2019)

• Record Type: Journal Article
• Authors: Tajima, Hiroshi; Kasai, Hajime; Tanabe, Nobuhiro; Sugiura, Toshihiko; Miwa, Hideki; Naito, Akira; Suda, Rika; Nishimura, Rintaro; Sanada, Takayuki Jujo; Sakao, Seiichiro; Tatsumi, Koichiro
• Is Part Of: Pulmonary circulation. Volume 9:Number 1(2019)
• Publication Date: 2019-03
• Subjects: antipsychotic drugs -- chronic thromboembolic pulmonary hypertension -- psychiatric disorders -- pulmonary embolism -- respiratory function; Pulmonary circulation -- Periodicals; Pulmonary circulation; Electronic journals -- Sciences; Periodicals; 616.24005
• DOI: 10.1177/2045894019836420
• Languages: English
• ISSNs: 2045-8932

Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) can cause right heart failure. A concomitant psychiatric disorder (PD) is thought to increase the risk of acute pulmonary thromboembolism; however, whether PDs are associated with deterioration in CTEPH pathophysiology is unclear. In this study, we evaluated the clinical characteristics and prognoses in patients with CTEPH and a co-existing PD. We retrospectively identified 229 consecutive patients (mean age = 58.7 ± 12.5 years; 160 women) with CTEPH and categorized them according to whether they had a PD (PD group; n = 22, 9.7%) or not (non-PD group; n = 207, 90.3%). We compared the clinical characteristics, respiratory function, hemodynamics, and clinical courses in the two groups. Those in the PD group had significantly lower exercise tolerance compared to the non-PD group (6-min walk test, 309.5 ± 89.5 m vs. 369.4 ± 97.9 m, P = 0.008, percent vital capacity 85.5% ± 17.3% vs. 96.0% ± 15.5%, P = 0.003) and partial pressure of oxygen (PaO2 ) (54.4 ± 8.6 mmHg vs. 59.3 ± 10.7 mmHg, P = 0.039). Three-year survival was significantly poorer in the PD group compared to the non-PD group (66.1% vs 89.7%, P = 0.0026, log-rank test), particularly in patients who underwent surgery (62.2% vs 89.5%, P < 0.001, log-rank test). A concomitant PD was associated with low exercise tolerance and impaired respiratory function in patients with CTEPH and predicted poor survival, especially in those who underwent a pulmonary endarterectomy.