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Prevalence and Characteristics of Pulmonary Hypertension Associated with COPD – A Pilot Study in Patients Referred to a Pulmonary Rehabilitation Program Clinic
Objectives: Pulmonary hypertension (PH) is a common complication of chronic obstructive pulmonary disease (COPD); its prevalence is currently unknown. The objectives of the study were: (a) to pro vide data on the prevalence of PH among the COPD patients referred to a pulmonary rehabilitation program; (b) to evaluate possible correlations of PH with the severity of COPD, the presence of hypoxemia and polycythemia.
Material and methods: We retrospectively studied 31 consecutive patients with the diagnosis of COPD hospitalised in our clinic in which echocardiography was performed. Spirometry, peripheral oxygen saturation, haematocrit, echocardiography data, history of exacerbations and cardiac comorbidities were obtained from patients records. PH was defined as systolic pulmonary arterial pressure (sPAP) greater than 35 mmHg or by the presence of right ventricle (RV) abnormalities.
Outcomes: The prevalence of PH was 38.7%. Resting hypoxemia was significantly more frequent in the PH group than in the non PH patients (p=0.019). Other differences were not statistically significant (severity of bronchial obstruction and polycythemia, cardiac comorbidities). The impact of PH on RV was found in only 5 patients with RV enlargement; no patient had RV hypertrophy or RV systolic dysfunction. Suspected “out of proportion” PH (sPAP greater than 50 mmHg) was encountered in 2 out of 12 patients with PH.
Conclusions: The prevalence of PH in patients with COPD was 38.7%. Resting hypoxemia was significantly more frequent in PH patients. As PH has an important role in the prognosis of COPD patients, it should be evaluated in as many COPD patients as possible.
Keywords: pulmonary hypertension, chronic obstructive pulmonary disease, echocardiography