Clinical and functional features and quality of life in depressive disorders in patients undergoing pulmonary thromboendarterectomy

• Published in: Rossiĭskiĭ kardiologicheskiĭ zhurnal Vol. 27; no. 8; p. 5154
• Main Authors: Kamenskaya, O. V., Klinkova, A. S., Loginova, I. Yu, Porotnikova, S. S., Volkova, I. I., Lomivorotov, V. N., Chernyavskiy, A. M.
• Format: Journal Article
• Language: English; Russian
• Published: FIRMA «SILICEA» LLC 01-09-2022
• Subjects: chronic thromboembolic pulmonary hypertension; depression; quality of life
• ISSN: 1560-4071; 2618-7620
• DOI: 10.15829/1560-4071-2022-5154

Aim.
To conduct a comparative analysis of clinical and functional parameters and quality of life (QoL) in patients with chronic thromboembolic pulmonary hypertension (CTEPH), depending on the presence of a depressive disorder in long-term postoperative period.
Material and methods
. The study included 182 patients with CTEPH in the long term after surgery. Depending on the Patient Health Questionnaire 9 ( PHQ-9) data, all patients were divided into 2 groups: the 1
st
group — patients without depressive syndrome in the long-term postoperative period, the 2
nd
— patients with depressive syndrome. A comparative assessment of the initial clinical and functional characteristics, as well as QoL was carried out using the SF-36 questionnaire in both groups of patients. In patients who had a coronavirus disease 2019 (COVID-19), a comparative assessment using the Post-COVID-19 Functional Status (PCFS) scale was carried out.
Results.
Clinically relevant depressive syndrome in patients with CTEPH in the long term after surgery was registered in 25,3% of cases. In the 2
nd
group of patients, prior myocardial infarction (p=0,02), concomitant chronic cerebrovascular disease (p=0,01), as well as moderate and severe post-COVID-19 functional limitations according to the PCFS scale (p=0,004) were significantly more often recorded compared with the 1
st
group. In the 2
nd
group of patients, the level of QoL in almost all parameters was significantly lower in comparison with the 1st group (p<0,05). Decreased QoL (score <40) in the 2
nd
group concerned numerous parameters, including the physical and mental health components. In the 1
st
group of patients, reduced QoL was observed only in some physical parameters.
Conclusion.
The group of patients with CTEPH with depressive syndrome in the long-term postoperative period was characterized by a higher incidence of concomitant chronic cerebrovascular disease and a history of myocardial infarction compared with patients without depressive disorders. In the group of patients with depressive disorders, moderate and severe post-COVID-19 functional limitations according to the PCFS scale were more often observed. Depressive disorders in patients with CTEPH in the long-term postoperative period were accompanied by significantly reduced QoL parameters. Patients experienced the greatest difficulties both during normal daily activities and in professional activities.