Pulmonary Hypertension Complicating Interstitial Lung Disease and COPD

Shino, Michael Y.; Lynch, Joseph P.; Saggar, Rajeev; Abtin, Fereidoun; Belperio, John A.; Saggar, Rajan

doi:10.1055/s-0033-1356548

Cited by 16 publications

(3 citation statements)

References 221 publications

(380 reference statements)

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“…The EQ-5D health questionnaire was applied to assess the QoL for COPD patients [ 7 , 9 ]. The self-classifier consists of five dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), each with three levels of response (level 1 = no problems, level 2 = some problems, or level 3 = inability or extreme problems).…”

Section: Methodsmentioning

confidence: 99%

“…A number of studies found that proper health interventions could both improve the quality of life (QoL) and reduce the medical costs of COPD patients [ 6 - 8 ]. QoL is likely an important predictor for subsequent COPD exacerbation, hospitalization and mortality, and is related to the severity of COPD, which all are measures associated with a high healthcare expenditure [ 9 - 12 ]. Also, QoL is strongly associated with investment beliefs and their behaviors including healthcare seeking [ 13 - 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Quality of life and its association with direct medical costs for COPD in urban China

Zhao

Chen

et al. 2015

Health Qual Life Outcomes

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BackgroundChronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide. Few studies have focused on the quality of life (QoL) associated medical costs for COPD in China.MethodsA cross-sectional survey of 678 COPD patients was conducted in four major cities (Beijing, Shanghai, Guangzhou and Chengdu), China, in 2011. Data on socio-demographic information, health conditions and medical costs were collected through a face-to-face interview combined with medical record searching. The EuroQol (EQ-5D) health questionnaire was applied to assess the QoL of COPD patients.ResultsAmong 678 patients with COPD, nearly 40% had difficulties in mobility, usual activities and pain/discomfort, one third had various degrees of anxiety/depression, and one fifth had difficulties in self-care. The COPD patients had a median utility score of 0.768 and a median visual analog scale score of 70. The degree of difficulties in any dimensions significantly increased, and utility and health scores decreased with severity of the disease. Age, gender and disease severity were significantly associated with the quality of life after taking other covariates into consideration. Poorer QoL was a significant indicator of higher direct medical costs for COPD patients.ConclusionImpaired quality of life was significantly linked to increased medical costs for COPD patients and could be an important measure for policy- and decision-making in COPD care.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Quality of life and its association with direct medical costs for COPD in urban China

Zhao

Chen

et al. 2015

Health Qual Life Outcomes

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“…PH associated with lung disease has the worst prognosis of all types of PH [2]. The prevalence of PH in both chronic lung diseases depends on the severity of the disease and the definition and methodologies used in the studies [3, 4]. Most of the available data regarding PH-lung disease comes from patients undergoing evaluation for lung transplantation (LTx).…”

Section: Introductionmentioning

confidence: 99%

Pulmonary arterial wall disease in COPD and interstitial lung diseases candidates for lung transplantation

et al. 2017

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BackgroundPulmonary hypertension (PH) associated with lung disease has the worst prognosis of all types of PH. Pulmonary arterial vasculopathy is an early event in the natural history of chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD). The present study characterized the alterations in the structure and function of the pulmonary arterial (PA) wall of COPD and ILD candidates for lung transplantation (LTx).MethodsA cohort of 73 patients, 63 pre-LTx (30 COPD, 33 ILD), and ten controls underwent simultaneous right heart catheterisation and intravascular ultrasound (IVUS). Total pulmonary resistance (TPR), capacitance (Cp), and the TPR-Cp relationship were assessed. PA stiffness and the relative area of wall thickness were estimated as pulse PA pressure/IVUS pulsatility and as [(external sectional area-intimal area)/external sectional area] × 100, respectively.ResultsTwenty-seven percent of patients had pulmonary arterial wedge pressure > 15 mmHg and were not analyzed. PA stiffness and the area of wall thickness were increased in comparison with controls, even in patients without PH (p < 0.05). ILD patients showed a significant higher PA stiffness, and lower Cp beyond mean PA pressure (mPAP) and lower area of wall thickness than COPD patients (p < 0.05). TPR-Cp relationship was shifted downward left for ILD patients.ConclusionsSignificant increase of PA stiffness and area of wall thickness were present even in patients without PH and can make the diagnosis of pulmonary vasculopathy at a preclinical stage in PH-lung disease candidates for LTx. ILD patients showed the worst PA stiffness and Cp with respect to COPD.

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