Clinical characteristics and prediction of pulmonary hypertension in severe emphysema

Minai, Omar A.; Fessler, H; Stoller, James K.; Criner, Gerard J.; Scharf, Steven M.; Meli, Yvonne; Nutter, Benjamin; DeCamp, Malcolm M.

doi:10.1016/j.rmed.2013.11.006

Cited by 30 publications

(25 citation statements)

References 28 publications

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“…This might be hampered by the lack of echocardiographic data in 130 patients. Not only has research shown a high prevalence of PH in COPD patients [35,36], but PH is also known to be of importance in NCFB as right ventricular dysfunction and right ventricular dimensions are greater in cystic NCFB and are positively correlated with systolic pulmonary artery pressure and negatively correlated with partial pressure of oxygen in arterial blood. In more severe NCFB, there is an impaired perfusion with more capillary bed destruction and left-to-right shunt, leading to impaired cardiac function and pulmonary gas exchange [37].…”

Section: Discussionmentioning

confidence: 99%

Mortality in non-cystic fibrosis bronchiectasis: A prospective cohort analysis

Goeminne¹,

Nawrot

Ruttens³

et al. 2014

Respiratory Medicine

157

126

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Section: Discussionmentioning

confidence: 99%

Mortality in non-cystic fibrosis bronchiectasis: A prospective cohort analysis

Goeminne¹,

Nawrot

Ruttens³

et al. 2014

Respiratory Medicine

157

126

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“…We also collected survival data. We calculated the FEV 1 /D LCO , which has been shown to be a potential predictor of precapillary PH in COPD patients [16]. …”

Section: Methodsmentioning

confidence: 99%

Pulmonary Arterial Hypertension-Specific Drug Therapy in COPD Patients with Severe Pulmonary Hypertension and Mild-to-Moderate Airflow Limitation

Calcaianu¹,

Canuet²,

Schüller³

et al. 2015

Respiration

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Background: Patients with severe pulmonary hypertension (PH) associated with chronic obstructive pulmonary disease (COPD) present a poor outcome. Specific PH treatment could improve the clinical and hemodynamic status of these patients but may worsen arterial blood gases. Objectives: Our study retrospectively included 28 patients with severe precapillary PH (mean pulmonary arterial pressure >35 mm Hg) associated with mild-to-moderate COPD [forced expiratory volume in 1 s (FEV₁) >50% predicted]. All patients underwent specific pulmonary arterial hypertension (PAH) treatment as mono-, bi- or triple therapy. Methods: Our single-center study was conducted based on retrospective data of 537 right heart catheterizations (RHCs) performed on patients with COPD from January 2004 to June 2014. An echocardiography, comprehensive blood tests, pulmonary function tests, and a high-resolution computed tomography were performed before the RHCs. All patients underwent RHC with a Swan-Ganz catheter. Results: Compared to baseline, patients treated with specific PAH drugs showed a significant increase in cardiac index at long term (2.5 ± 0.7 liters/min/m² at baseline vs. 3.2 ± 0.6 liters/min/m² at 6/12 months; p = 0.003) as well as a decrease in pulmonary vascular resistance in the long term (8.4 ± 4.2 Wood units at baseline vs. 5 ± 1.7 Wood units at 6/12 months; p = 0.008). There was a slight decrease in arterial oxygen tension (PaO₂) after 3 months of treatment (-2.4 ± 7.21 mm Hg; p = 0.066). During a median follow-up of 3 years, 12 patients (42.8%) died (including all causes of death). Conclusions: This preliminary report suggests that the use of specific PH therapy in severe PH associated with mild-to-moderate COPD can improve pulmonary hemodynamic parameters, with worsening of PaO₂, which had no clinical significance and did not lead to specific PAH therapy withdrawal in any patient.

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“…In a recent study looking at 797 patients enrolled in the NETT trial who received right heart catheterization, only 2.2 % had severe PH, defined by a mean PAP > 35 mmHg. Interestingly severe pulmonary hypertension, often defined by echo, was an exclusion criteria for this trial (Minai et al 2014). Other studies show a prevalence of 1-10 % depending on whether severe PH is defined as a mPAP of 35 or 40 mmHg (Thabut et al 2005;Scharf et al 2002;Chaouat et al 2005).…”

Section: Chronic Obstructive Pulmonary Diseasementioning

confidence: 97%