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Pulmonary artery pressure in chronic obstructive pulmonary disease without resting hypoxaemia

Authors: Lee, J. H.1; Oh, Y-M.2; Seo, J. B.3; Lee, Y. K.4; Kim, W. J.5; Sheen, S. S.6; Kim, T-H.7; Lee, J-H.8; Kim, E-K.8; Lee, J. S.2; Huh, J. W.2; Lim, S. Y.9; Yoon, H. I.10; Shin, T. R.11; Lee, S-M.; Lee, S. Y.12; Lee, S-D.2

Source: The International Journal of Tuberculosis and Lung Disease, Volume 15, Number 6, June 2011 , pp. 830-837(8)

Publisher: International Union Against Tuberculosis and Lung Disease

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Abstract:

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 (FEV1) 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 FEV1% predicted, sPAP and Hb concentration as variables indicated three patient clusters: Cluster 1 (n = 36; mean FEV1 44% predicted, mean sPAP 39 mmHg, mean Hb 132 g/l), Cluster 2 (n = 45; FEV1 35% predicted, sPAP 31 mmHg, Hb 154 g/l), and Cluster 3 (n = 36; FEV1 65% predicted, sPAP 29 mmHg, Hb 148 g/l).

CONCLUSION: Elevated PAP was linked to low haemoglobin levels in COPD without resting hypoxaemia.

Keywords: COPD; echocardiography; haemoglobin; pulmonary artery pressure

Document Type: Regular Paper

DOI: http://dx.doi.org/10.5588/ijtld.10.0598

Affiliations: 1: Department of Internal Medicine, Ewha Womans University School of Medicine, Ewha Medical Research Institute, Seoul, Republic of Korea 2: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Seoul, Republic of Korea 3: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Research Institute of Radiology, Seoul, Republic of Korea 4: Department of Radiology, East West Neo Medical Center, Kyunghee University School of Medicine, Seoul, Republic of Korea 5: Department of Internal Medicine, College of Medicine, Kangwon National University, Chuncheon, Republic of Korea 6: Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Republic of Korea 7: Division of Pulmonology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea 8: Department of Internal Medicine, Bundang CHA Hospital, University of Pocheon Jungmoon College of Medicine, Seongnam, Republic of Korea 9: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea 10: Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea 11: Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea 12: Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Korea University Anam Hospital, Seoul, Republic of Korea

Publication date: June 1, 2011

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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