One-year prognosis and quality of life after treatment in severe vs non-severe pulmonary hypertension patients

Pulmonary hypertension (PH) is a progressive disease associated with high morbidity, deterioration in quality of life, and mortality. It is defined by elevated pulmonary artery pressure (mPAP >20 mmHg) and pulmonary vascular resistance (>2 Wood units), leading to right heart failure and premature death if untreated. PH causes significant symptoms like breathlessness and fatigue, which greatly reduces quality of life. Advanced stages carry a high risk of death, with one-year mortality rates between 15% and 30%, highlighting the need for early diagnosis and treatment to improve outcomes. Despite therapeutic advances, the evolution of prognosis and quality of life after the initiation of treatment has not been fully characterized. Thus, this study aims to systematically evaluate prognostic changes and quality of life in patients with pulmonary hypertension treated for one year at a referral hospital, comparing those with severe versus non-severe disease. An observational, longitudinal, and analytical study was conducted in patients with a confirmed PH diagnosis. The diagnosis was made by cardiac catheterization, mean pulmonary pressure ≥ 20 mmHg, and classified according to whether they were precapillary (interstitial pressure <15 and pulmonary vascular resistance > 2 wood units), postcapillary (interstitial pressure >15, pulmonary vascular resistance <2 UW), or combined (interstitial pressure >15 mmHg, and resistance >2UW). Following was assessed every 3 months over 12 months: WHO/NYHA functional class (SGRQ, HADS, and EQ-5D), risk, and mortality. The sample consisted of 33 patients, with an average age of 62.6 years and 81.8% of whom were female. Patients with severe pulmonary hypertension demonstrated significantly higher pulmonary vascular resistance and lower TAPSE/PSAS ratios compared with non-severe cases. Functional class improved significantly from 2.09 ± 0.8 to 1.70 ± 0.8 at 12 months. Risk stratification shifted toward lower-risk categories during follow-up. Quality of life scores (SGRQ and EQ-5D) showed significant changes in comparison with the basal line, while HADS scores remained stable. The one-year mortality rate was 6.1%. Specific treatment for PH resulted in clinical and functional improvements over a one-year follow-up period, although risk stratification showed an unfavorable trend.