HEALTH-RELATED QUALITY OF LIFE ACROSS THE SPECTRUM OF PULMONARY HYPERTENSION IN PVDOMICS

Abstract

SESSION TITLE: Pulmonary Vascular Disease Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Health related quality of life (HRQOL) is frequently impaired and predictive of survival in pulmonary arterial hypertension (PAH). However, little is known about HRQOL in other forms of pulmonary hypertension (PH). PVDOMICS (Redefining Pulmonary Hypertension through Pulmonary Vascular Disease Phenomics) is a NIH-sponsored, multi-center, observational study of patients with PH and those at-risk for PH. Using this large cohort of patients with various forms of PH, we sought to characterize HRQOL across groups of the World Symposium on Pulmonary Hypertension (WSPH) classification system. METHODS: Enrollees underwent cardiac imaging, pulmonary function testing, six-minute walk testing (6MWT), and right heart catheterization. HRQOL was assessed using emPHasis-10 (e-10), Medical Outcomes Survey Short Form-36 (SF-36; physical component (PCS) and mental component (MCS)), and Minnesota Living with Heart Failure Questionnaire (MLHF). HRQOL measures were summarized as means (SD) and were compared between WSPH groups using ANOVA and t-tests. Pearson’s correlation assessed the relationship between HRQOL and demographic, physiologic, and imaging characteristics. RESULTS: Of the 763 subjects enrolled, 372 were in Group 1, 145 in Group 2, 160 in Group 3, 58 in Group 4, and 28 in Group 5. Age and sex significantly differed between groups; most subjects were white (n=580, 78%) and had moderate functional impairment by 6MWT (mean 350±134 m). Hemodynamics showed mild to moderate severity PH. Overall, HRQOL was severely depressed and differed significantly across WSPH groups except for the MCS score of the SF-36. When compared to Group 1, Group 2 subjects had significantly worse e-10 (28.1(11.5) vs. 23.5(12.9), p=0.002), PCS (32.5(7.9) vs. 38.5(10.1), p<0.001), and MLHF (50.2(26.2) vs. 39.9(28.2), p=0.003). Group 3 subjects had worse e-10 (30.1(11.6) vs. 23.5(12.9), p<0.001) and PCS (32.9(8.7) vs. 38.5(10.1), p<0.001) compared to Group 1. There were no significant differences in HRQOL noted between Group 1 and Group 4 or 5 patients. There were weak but statistically significant associations between HRQOL measures and hemodynamics in Group 1 and Group 3, but not in Groups 2,4, or 5. Overall, there were modest correlations between HRQOL measures and 6MWT that were strongest in Group 1. CONCLUSIONS: HRQOL is depressed across the spectrum of PH. Group 2 and Group 3 patients have worse HRQOL than Group 1 patients despite less severe PH. HRQOL does not strongly associate with hemodynamic perturbations but is modestly associated with 6MWT. These data suggest that the impact of PH on HRQOL is not related to hemodynamic severity and differs between PH groups. CLINICAL IMPLICATIONS: HRQOL differs between PH groups and appears independent from hemodynamic severity, suggesting current assessment of disease severity by hemodynamic metrics may underestimate disease impact from the patient’s perspective DISCLOSURES: No relevant relationships by Aparna Balasubramanian, source=Web Response No relevant relationships by Erika Berman Rosenzweig, source=Web Response Advisory Committee Member relationship with Liquidia Please note: $1001 - $5000 Added 03/19/2020 by Robert Frantz, source=Web Response, value=Consulting fee Advisory Committee Member relationship with Altavant Please note: $1001 - $5000 Added 03/19/2020 by Robert Frantz, source=Web Response, value=Consulting fee Advisory Committee Member relationship with Actelion Please note: $5001 - $20000 Added 07/16/2020 by Robert Frantz, source=Web Response, value=Consulting fee No relevant relationships by Paul Hassoun, source=Web Response Advisory Committee Member relationship with bayer Please note: $1001 - $5000 Added 04/14/2020 by Anna Hemnes, source=Web Response, value=Consulting fee Advisory Committee Member relationship with Complexa Please note: $1-$1000 Added 04/14/2020 by Anna Hemnes, source=Web Response, value=Consulting fee Advisory Committee Member relationship with United Therapeutics Please note: $1001 - $5000 Added 04/14/2020 by Anna Hemnes, source=Web Response, value=Consulting fee Advisory Committee Member relationship with actelion Please note: $1001 - $5000 Added 04/14/2020 by Anna Hemnes, source=Web Response, value=Consulting fee Scientific Medical Advisor relationship with PHPreMedicine Please note: $1-$1000 Added 04/14/2020 by Anna Hemnes, source=Web Response, value=Ownership interest no disclosure on file for Evelyn Horn; My spouse/partner as a Consultant relationship with Cellectis Please note: >$100000 Added 05/28/2020 by Jane Leopold, source=Web Response, value=Consulting fee Clinical Trial Steering Committee relationship with Actelion Please note: $1001 - $5000 Added 05/27/2020 by Stephen Mathai, source=Web Response, value=Consulting fee Consultant relationship with Liquidia Please note: $1001 - $5000 Added 05/27/2020 by Stephen Mathai, source=Web Response, value=Consulting fee Consultant relationship with United Therapeutics Please note: $1001 - $5000 Added 05/27/2020 by Stephen Mathai, source=Web Response, value=Consulting fee My spouse/partner as a Consultant relationship with GSK Please note: $1001 - $5000 Added 05/27/2020 by Stephen Mathai, source=Web Response, value=Consulting fee My spouse/partner as a Consultant relationship with Celegene Please note: $1001 - $5000 Added 05/27/2020 by Stephen Mathai, source=Web Response, value=Consulting fee My spouse/partner as a Royalty relationship with Up To Date Please note: $1001 - $5000 Added 05/27/2020 by Stephen Mathai, source=Web Response, value=Royalty no disclosure on file for Franz Rischard