Effect of pulmonary hypertension on exercise tolerance in patients with COPD : A prognostic systematic review and meta-analysis
Torres-Castro, Rodrigo (Dept of Physical Therapy. Faculty of Medicine. University of Chile)
Gimeno-Santos, Elena (Barcelona Institute for Global Health (ISGlobal))
Vilaró, Jordi (Universitat Ramon Llull)
Roqué i Figuls, Marta (Institut d'Investigació Biomèdica Sant Pau)
Moisés, Jorge (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Vasconcello-Castillo, Luis (Dept of Physical Therapy. Faculty of Medicine. University of Chile)
Orizaga, Tania (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Barberà i Mir, Joan Albert (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Blanco, Isabel (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)

Date:	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.
Grants:	Instituto de Salud Carlos III PI17/1515
Note:	Altres ajuts: Fondo Europeo de Desarrollo Regional (FEDER), Unión Europea "Una manera de hacer Europa"; Sociedad Española de Neumología y Cirugía Torácica (SEPAR); Societat Catalana de Pneumologia (SOCAP); National Agency for Research and Development (ANID Scholarship Program/DOCTORADO BECAS CHILE/2018-72190117).
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:	Exercise Test ; Exercise Tolerance ; Humans ; Hypertension, Pulmonary ; Prognosis ; Pulmonary Disease, Chronic Obstructive
Published in:	European Respiratory Review, Vol. 30 Núm. 160 (2021) , p. 200321, ISSN 1600-0617

DOI: 10.1183/16000617.0321-2020
PMID: 33927006

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
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