Pulmonary hypertension in COPD: Is it always the consequence of end-stage disease?

Pulmonary & Respiratory Medicine

ISSN: 2161-105X

Open Access

Pulmonary hypertension in COPD: Is it always the consequence of end-stage disease?

3rd International Conference on Chronic Obstructive Pulmonary Disease

July 11-12, 2016 Brisbane, Australia

Monika Szturmowicz

National Tuberculosis and Lung Diseases Research Institute, Poland

Posters & Accepted Abstracts: J Pulm Respir Med

Abstract :

Pulmonary hypertension (PH) defi ned as mean resting pulmonary artery pressure (mPAP) equal or higher than 25 mm Hg (measured directly), is found in 50% of the patients with end-stage COPD. In most cases mild PH is observed. Nevertheless in 2-7% of patients, severe PH (defi ned as mPAP>35 mm Hg or CI<2.5 l/min) develops. What�s most interesting, severe PH in COPD is not always combined with end-stage disease. Th e diff erential diagnosis on such occasion should exclude the infl uence of other comorbidities on PH (left heart disease, venous thromboembolism and sleep disordered breathing). Latest publications indicate that clinical phenotype of severe PH in COPD is characterized by profound hypoxemia, hypocapnia and very low diff usion capacity of the lung for carbon dioxide (DLCO), despite mild or moderate airway obstruction. It is still not known, if such phenotype is combined with certain genetic rearrangements. According to latest PH guidelines, optimal COPD treatment combined with long term oxygen therapy in the patients with PaO2 below 60 mm Hg is indicated in PH-COPD. Nevertheless in the patients with severe PH, the referral to an expert center is advised. Latest results of clinical trials with PH-specifi c drugs are disappointing. Despite the improvement in pulmonary hemodynamics, no signifi cant changes in exercise capacity or quality of life of the patients are reported. Future research should be directed towards the identifi cation of those PH-COPD patients, in whom maximal exercise capacity is limited by low cardiac output, and not by the exhausted ventilatory reserve.

Biography :


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