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2015-07-14

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cc-by-nc (c) Portillo, K. et al., 2015
Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/67820

Pulmonary hemodynamic profile in chronic obstructive pulmonary disease

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http://dx.doi.org/10.2147/COPD.S78180

Abstract

Introduction: Few data are available in regards to the prevalence of pulmonary hypertension (PH) in the broad spectrum of COPD. This study was aimed at assessing the prevalence of PH in a cohort of COPD patients across the severity of airflow limitation, and reporting the hemodynamic characteristics at rest and during exercise. Methods: We performed a retrospective analysis on COPD patients who underwent right-heart catheterization in our center with measurements obtained at rest (n=139) and during exercise (n=85). PH was defined as mean pulmonary artery pressure (mPAP) >/25 mmHg and pulmonary capillary wedge pressure <15 mmHg. Exercise-induced PH (EIPH) was defined by a ratio of ΔmPAP/Δcardiac output >3. Results: PH was present in 25 patients (18%). According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, PH prevalence in GOLD 2 was 7% (3 patients); 25% (14 patients) in GOLD 3; and 22% (8 patients) in GOLD 4. Severe PH (mPAP >/35 mmHg) was identified in four patients (2.8%). Arterial partial oxygen pressure was the outcome most strongly associated with PH (r=-0.29, P<0.001). EIPH was observed in 60 patients (71%)and had a similar prevalence in both GOLD 2 and 3, and was present in all GOLD 4 patients. Patients with PH had lower cardiac index during exercise than patients without PH (5.0±1.2 versus 6.7±1.4 L/min/m2 ,respectively; P=0.001). Conclusion: PH has a similar prevalence in COPD patients with severe and very-severe airflow limitation, being associated with the presence of arterial hypoxemia. In contrast, EIPH is highly prevalent, even in moderate COPD, and might contribute to limiting exercise tolerance.

Subject

Malalties pulmonars obstructives cròniques, Hipertensió pulmonar

Subject (English)

Chronic obstructive pulmonary diseases, Pulmonary hypertension

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Articles publicats en revistes (Medicina)

Citation

PORTILLO, Karina, et al. Pulmonary hemodynamic profile in chronic obstructive pulmonary disease. International Journal of Chronic Obstructive Pulmonary Disease. 2015. Vol. 10, num. 1313-1320. ISSN 1176-9106. [consulted: 12 of August of 2026]. Available at: https://hdl.handle.net/2445/67820

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