Pulmonary hemodynamic profile in chronic obstructive pulmonary disease
Portillo, Karina (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Torralba, Yolanda (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Blanco, Isabel (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Burgos, Felip (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Rodríguez-Roisin, Robert (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Rios, Jose (Universitat Autònoma de Barcelona. Departament de Psicobiologia i de Metodologia de Ciències de la Salut)
Roca, Josep (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Barberà i Mir, Joan Albert (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)

Date:	2015
Abstract:	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. 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. 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/m 2, respectively; P =0. 001). 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.
Grants:	Instituto de Salud Carlos III EC07-90049
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Pulmonary hypertension ; Right heart catheterization ; Cardiac index ; GOLD
Published in:	International journal of COPD, Vol. 10 (july 2015) , p. 1313-1320, ISSN 1178-2005

DOI: 10.2147/COPD.S78180
PMID: 26203238

8 p, 467.7 KB

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