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Title: | Effect of pulmonary hypertension on exercise tolerance in patients with COPD: a prognostic systematic review and meta-analysis |
Author: | Torres Castro, Rodrigo Gimeno Santos, Elena Vilaró, Jordi Roqué Figuls, Marta Moisés, Jorge Vasconcello Castillo, Luis Orizaga, Tanya Barberà i Mir, Joan Albert Blanco Vich, Isabel |
Keywords: | Malalties pulmonars obstructives cròniques Hipertensió pulmonar Chronic obstructive pulmonary diseases Pulmonary hypertension |
Issue Date: | 29-Apr-2021 |
Abstract: | Background: Pulmonary hypertension (PH) is a frequent complication in patients with COPD. Objective: To determine if, in patients with COPD, the presence of PH decreases exercise tolerance. Methods: We included studies that analysed exercise tolerance using a cardiopulmonary exercise test (CPET) in patients with COPD with PH (COPD-PH) and without PH (COPD-nonPH). Two independent reviewers analysed the studies, extracted the data and assessed the quality of the evidence. Results: Of the 4915 articles initially identified, seven reported 257 patients with COPD-PH and 404 patients with COPD-nonPH. The COPD-PH group showed differences in peak oxygen consumption (V'O2peak ), -3.09 mL·kg-1·min-1 (95% CI -4.74 to -1.43, p=0.0003); maximum workload (Wmax), -20.5 W (95% CI -34.4 to -6.5, p=0.004); and oxygen pulse (O2 pulse), -1.24 mL·beat-1 (95% CI -2.40 to -0.09, p=0.03), in comparison to the group with COPD-nonPH. If we excluded studies with lung transplant candidates, the sensitivity analyses showed even bigger differences: V'O2 , -4.26 mL·min-1·kg-1 (95% CI -5.50 to -3.02 mL·kg-1·min-1, p<0.00001); Wmax, -26.6 W (95% CI -32.1 to -21.1 W, p<0.00001); and O2 pulse, -2.04 mL·beat-1 (95% CI -2.92 to -1.15 mL·beat-1, p<0.0001). Conclusion: Exercise tolerance was significantly lower in patients with COPD-PH than in patients with COPD-nonPH, particularly in nontransplant candidates. |
Note: | Reproducció del document publicat a: https://doi.org/10.1183/16000617.0321-2020 |
It is part of: | European Respiratory Review, 2021, vol. 30, num. 160, p. 200321 |
URI: | http://hdl.handle.net/2445/183674 |
Related resource: | https://doi.org/10.1183/16000617.0321-2020 |
ISSN: | 0905-9180 |
Appears in Collections: | Articles publicats en revistes (Medicina) Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) |
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