Severe pulmonary hypertension associated with chronic obstructive pulmonary disease: A prospective French multicenter cohort
| Autor: | Cédric Laouénan, Gérald Simonneau, Bruno Degano, David Montani, Vincent Cottin, Clément Boissin, Martine Reynaud-Gaubert, Yolande Costa de Beauregard, Olivier Sitbon, Marc Humbert, Drifa Belhadi, Amina Bencherif, Emmanuel Bergot, Hervé Mal, Ari Chaouat, Olivier Sanchez, Mathieu Canuet, Grégoire Prévot, Cécile Tromeur, G. Dauriat, Bouchra Lamia, Gabriel Thabut |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Exacerbation Hypertension Pulmonary 030204 cardiovascular system & hematology Pulmonary function testing Pulmonary Disease Chronic Obstructive 03 medical and health sciences 0302 clinical medicine Interquartile range medicine.artery Internal medicine medicine Humans Prospective Studies Pulmonary Wedge Pressure Pulmonary wedge pressure Aged Transplantation COPD business.industry Incidence Middle Aged medicine.disease Pulmonary hypertension Respiratory Function Tests medicine.anatomical_structure 030228 respiratory system Pulmonary artery Cardiology Vascular resistance Female Vascular Resistance Surgery France Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The Journal of Heart and Lung Transplantation. 40:1009-1018 |
| ISSN: | 1053-2498 |
| Popis: | Background A small proportion of patients with chronic obstructive pulmonary disease (COPD) patients present severe pulmonary hypertension (PH), defined by mean pulmonary artery pressure (mPAP) ≥35 mm Hg measured by right heart catheterization. Little is known about the characteristics of severe PH-COPD. The aim of the study based on a national registry was to describe this phenotype. Methods We prospectively included and followed patients with incident PH-COPD. Clinical, functional, hemodynamic data at inclusion and follow-up were retrieved. Survival assessed by Kaplan-Meier analysis was the primary end-point. Results From 2012 to 2016, 99 patients from 13 French centers were included in the study (82 males; median age 66.0 years [interquartile range 62.0-72.0]). At inclusion, most patients had marked dyspnea (55.6% and 22.2% New York Heart Association class III and IV, respectively). During 12 months before inclusion, 42.9% had an exacerbation requiring a hospitalization. Pulmonary function tests showed a moderate obstructive pattern with median (interquartile range) FEV1 50.0 [35.0-63.0] % predicted and low diffusing capacity for carbon monoxide, median 20.0 [16.5-30.6] % predicted. The median values for PaO2 and PaCO2 on room air were 50.0 [44.8-62.0] and 36.0 [31.1-43.0] mm Hg. Median values of mPAP, pulmonary artery occlusion pressure, cardiac index and pulmonary vascular resistance were 42.0 [37.0-48.0] mm Hg, 11.0 [9.0-14.0] mm Hg, 3.0 [2.4-3.6] L/min/m2, and 6.3 [4.2-7.9] WU, respectively. Mean restricted survival was 15.0 [13.9-16.0] months. Conclusions Severe PH-COPD is characterized by moderate airway obstruction but marked dyspnea and marked hypoxemia, low DLCO and high mPAP. This phenotype is associated with poor prognosis. |
| Databáze: | OpenAIRE |
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