The Pulmonary Arterial Hypertension Symptoms and Impact Questionnaire (PAH-SYMPACT) can reliably evaluate quality of life in patients with connective tissue disease-associated pulmonary arterial hypertension (CTD-PAH). It can also potentially be used in routine clinical practice to predict changes in a patient’s condition. 

This is according to a study published in the journal Pulmonary Circulation that aimed to validate the Chinese version of the questionnaire and explore its relationship with risk stratification in patients with CTD-PAH.

The PAH-SYMPACT is a patient-reported outcome scale specific to pulmonary arterial hypertension. It assesses patients’ quality of life from 4 aspects. These are cardiopulmonary symptoms, cardiovascular symptoms, physical impacts, and cognitive and emotional impacts.

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The current article reports on the results of cross-cultural adaptation of the PAH-SYMPACT in Chinese patients. 

A team of researchers led by Xiaofeng Zeng, MD, invited 75 patients with CTD-PAH who visited the outpatient clinic of the Department of Rheumatology at Peking Union Medical College Hospital from January 2019 to June 2020 to complete the Chinese version of PAH-SYMPACT as well as the 36-item medical outcomes study short form survey (SF-36) and the EuroQol five dimensions questionnaire (EQ-5D). 

The researchers collected demographic, clinical, laboratory, and treatment information about the patients. The endpoint was whether patients achieved their treatment goals 6 to 12 months after completing the questionnaires.

The team found that the Chinese version of the PAH-SYMPACT conformed the original questionnaire with reliability domains ranging from 0.83 to 0.88.

Patients’ treatment goal achievement status was significantly associated with their physical impacts scores.

“PAH-SYMPACT is a valid and reliable instrument for assessing the impact of the illness and its treatment on [quality of life]”, the researchers concluded. They added that the study provides a comprehensive analysis of the relationship between patients’ quality of life and clinical outcomes. Patients’ quality of life should be continually monitored as this could be a way to remotely detect the deterioration of the disease, they said.


Shi Y, Meng Y, Dong X, et al. Quality of life in ambulatory pulmonary arterial hypertension in connective tissue diseases and its relationship with risk stratification. Pulm Circ. Published online July 11, 2021. doi:10.1177/20458940211029899