Pulmonary artery pressure in chronic obstructive pulmonary disease without resting hypoxaemia

Abstract

THE DEVELOPMENT of pulmonary hypertension (PH) is often observed in advanced chronic obstructive pulmonary disease (COPD) and indicates a poor prognosis, with a 5-year survival rate of 20-36%. 1,2 PH primarily occurs in COPD patients with severe hypoxaemia; fortunately, however, the PH is typically mild. 3 Hypoxaemia increases pulmonary artery pres- S U M M A R Ysure (PAP) through hypoxic pulmonary vasoconstriction and vascular remodelling. 4 However, there is a poor correlation between lung function parameters and PAP, suggesting that factors other than airway obstruction and/or loss of alveolar surface may play a role in its aetiology.Recent studies have shown that a proportion of patients with only moderate airway obstruction have severe PH. 5,6 Disproportionate PH in COPD patients seems best defi ned as at least moderate elevation in SDL and YMO contributed equally to this article.

Study Design and Outcomes of Korean Obstructive Lung Disease (KOLD) Cohort Study

“…The ADRB2 gene polymorphism was associated with airway wall phenotypes as measured by CT, suggesting that it may be one of the determining factors of the radiological COPD phenotype17. In addition, cluster analysis identified distinct phenotypes in elderly with obstructive lung disease and factors related to pulmonary hypertension in COPD patients18,19. Furthermore, combining the analysis of KOLD with that of the Cohort for Reality and Evolution of Adult Asthma in Korea (COREA) has identified and characterized an overlap syndrome, which is an intermediate between asthma and COPD in clinical characteristics20.…”

Mechanisms of pulmonary hypertension in chronic obstructive pulmonary disease: A pathophysiologic review

“…Not surprisingly, earlier work has provided inconsistent data regarding this relationship. [67][68][69] Consequently, the role of polycythemia in the development of PHT remains unclear.…”

Phenotyping of chronic obstructive pulmonary disease: heterogeneity and its clinical relevance

“…Indeed, disproportionate PAH are observed in COPD patients with moderate airflow limitation. Low hemoglobin concentration may be associated with elevated PAP in this group [80]. Yet, there are few therapies that have been developed for PAH in COPD.…”