Pulmonary artery pressure in chronic obstructive pulmonary disease without resting hypoxaemia.
Lee, JH; Oh, YM; Seo, JB; Lee, YK; Kim, WJ; Sheen, SS; Kim, TH; Kim, EK; Lee, JS; Huh, JW; Lim, SY; Yoon, HI; Shin, TR; Lee, SM; Lee, SY; Lee, SD
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 15(6):830-837, 2011
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
BACKGROUND: Chronic obstructive pulmonary disease (COPD) can lead to pulmonary hypertension and cor pulmonale, which are predictors of mortality.
OBJECTIVE: To identify predictors of increased pulmonary artery pressure (PAP) in COPD patients without resting hypoxaemia, and to characterise COPD patients with increased PAP.
DESIGN: A study of 117 COPD patients from the Korean Obstructive Lung Disease (KOLD) cohort who had measurable tricuspid regurgitant flow under transthoracic Doppler echocardiography and no resting hypoxaemia.
RESULTS: The mean patient age was 67 years. Mean forced expiratory volume in 1 second (FEV(1)) was 47% predicted, mean haemoglobin (Hb) concentration was 145 g/l and mean systolic PAP (sPAP) was 33 mmHg. Multiple linear regression analysis showed that Hb was the only factor independently associated with sPAP (beta = -1.752, P = 0.005). Cluster analysis using FEV(1)% predicted, sPAP and Hb concentration as variables indicated three patient clusters: Cluster 1 (n = 36; mean FEV(1) 44% predicted, mean sPAP 39 mmHg, mean Hb 132 g/l), Cluster 2 (n = 45; FEV(1) 35% predicted, sPAP 31 mmHg, Hb 154 g/l), and Cluster 3 (n = 36; FEV(1) 65% predicted, sPAP 29 mmHg, Hb 148 g/l).
CONCLUSION: Elevated PAP was linked to low haemoglobin levels in COPD without resting hypoxaemia.
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