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J Heart Lung Transplant. 2014 Aug;33(8):800-8. doi: 10.1016/j.healun.2014.04.003. Epub 2014 Apr 19.

Emotional symptoms and quality of life in patients with pulmonary arterial hypertension.

Author information

Health Services and Nursing Research, Department of Public Health and Primary Care.
Respiratory Division, University Hospitals, and Department of Clinical and Experimental Medicine, University of Leuven, (KU Leuven) Leuven, Belgium.
TriloStatistical Consultancy, Basel, Switzerland.
Health Services and Nursing Research, Department of Public Health and Primary Care. Electronic address:



Limited evidence exists on the nature and degree of emotional problems in pulmonary arterial hypertension (PAH) and their association with patients' health-related quality of life (HRQOL).


This cross-sectional study examined the presence of depression, anxiety, and stress symptoms, and their association with disease-specific and generic HRQOL. A total of 101 patients (73% women) with PAH (age, 55.4 ± 16.4 years; 42.6% in New York Heart Association [NYHA] class II) completed the Depression, Anxiety, and Stress Scale, the generic Medical Outcomes Study Short-Form 36-Item (SF-36) Health Survey, and the disease-specific Minnesota Living With Heart Failure Questionnaire (MLHFQ) HRQOL instrument. The association between emotional problems and HRQOL was determined using multivariable linear regression analyses, controlling for demographic and disease-related characteristics.


Of the patients, 32.6%, 48%, and 27.6% experienced depressive, anxiety or stress symptoms, respectively. HRQOL was >1 standard deviation below population norms for the SF-36 Physical Component Summary. Depressive symptoms, NYHA class, and being disabled explained 46% of the total variance of the MLHFQ. Emotional problems did not contribute to the SF-36 Physical Component Summary but explained part of the variance of the physical sub-scales of the SF-36 role limitations due to physical problems, bodily pain, and general health.


The high presence of emotional problems warrants regular screening and appropriate psychotherapeutic and/or pharmacological treatment. Which strategies could improve PAH patients' HRQOL remains to be investigated.


Pulmonary arterial hypertension; mood problems; psychological functioning; quality of life

[Indexed for MEDLINE]

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