Annals of the American Thoracic Society · Jul 15, 2026

Frailty in Pulmonary Arterial Hypertension: A Cohort Study

By Farley GJ, Prakash M, Palevsky HI et al.

RATIONALE: Frailty is associated with increased morbidity and mortality. Patients with pulmonary arterial hypertension (PAH) are at a high risk of frailty; however, frailty has been understudied in PAH. OBJECTIVES: Understand the risk factors for and determine the impact of frailty on quality of life (QoL) and mortality in patients with PAH. METHODS: A prospective single center cohort enrolled 80 patients with PAH. Demographic, metabolic, hemodynamic, and QoL data were collected, and frailty was assessed via the Short Physical Performance Battery (SPPB) at baseline, 6-months and 12-months. Frailty or pre-frailty was defined as an SPPB score of ≤ 9. MEASUREMENTS AND MAIN RESULTS: In this cohort of patients with PAH, 49% were frail. Mean age was 57.6 years, 82.5% were female, and idiopathic (33.8%) and connective tissue disease associated (32.5%) PAH were the most common etiologies. Compared to non-frail patients, frail participants were significantly older, had greater mortality risk, and had significantly increased fat mass index, android-to-gynoid ratio, and visceral adipose tissue area. Higher levels of IL-6 were significantly associated with odds of frailty, although IL-6 did not mediate the association of body fat on frailty. Frail patients had worse QoL and worse transplant-free survival compared to non-frail patients. The percentage of patients with frailty increased over 1 year from 54.2% to 64.4%. CONCLUSIONS: Frailty was prevalent in this cohort of patients with PAH and was associated with older age, higher risk for mortality and body fat. Frailty in patients with PAH was associated with worse QoL and worse survival.

doi.org/10.1093/annalsats/aaoag198Open accessPubMed 42458805Biomarkers