Resting hypoxemia (r=-0.60, p<0.0001) and impaired diffusion capacity (r=-0.43, p=0.0187) were the primary predictors of elevated systolic pulmonary artery pressure in a cohort of COPD patients.
Cohort (n=167)
No
What is the prevalence and what are the predictors of pulmonary hypertension in a severe COPD cohort?
In a severe COPD cohort, the prevalence of probable pulmonary hypertension risk was 30.5%, with resting hypoxemia and impaired diffusion capacity being the primary predictors of severity.
Abstract Rationale Pulmonary Hypertension associated with Chronic Obstructive Pulmonary Disease (PH-COPD) is an important clinical entity, however its exact prevalence is not well established. We aimed to characterize the burden and potential predictors of elevated estimated systolic pulmonary artery pressure (sPAP) in 167 COPD patients from a tertiary university hospital (Hospital das Clínicas, USP, São Paulo, Brazil). Methods We performed a retrospective analysis. Our inclusion criteria were an established COPD diagnosis and, at least, one registered echocardiogram (ECHO). The most recent available ECHO was considered for analysis, and a total of 167 patients were eligible. 1. Prevalence: Probable PH (sPAP 35 mmHg) and potential severe PH (sPAP 60 mmHg) were calculated from the total cohort (N = 167). 2. Risk Factor Analysis: A “complete case” Pearson correlation was performed comparing measured sPAP (N = 92) against key variables (room air SatO2, DLCO % predicted, spirometric and clinical parameters). Significance was set at p 0.05. Results 1. Prevalence: The overall probable prevalence of PH risk in the total cohort was 30.5% (51/167), and potential severe PH prevalence was 5.4% (9/167) (Graph 1). 2. From the cohort, 75 patients (44.9%) did not have a measured sPAP, mainly by the inability to obtain a reliable tricuspid regurgitation velocity (TRV) jet signal due to absent or trivial regurgitation. Other minor causes were poor acoustic windows or beam-alignment difficulties with eccentric jets. 3. Distribution and Risk Factors: 96.4% of the patients presented GOLD 2 to 4 disease. The most robust predictor was room air SatO2 (r = -0.60, p 0.0001, N = 51). This correlation remained strong (r = -0.59, p = 0.0045) when analyzing only patients not on supplemental O2. The second significant predictor was DLCO % predicted (r = -0.43, p = 0.0187, N = 30). Interestingly, GOLD grade and spirometric values had no significant correlation. Conclusions The prevalence of PH risk in this COPD cohort is 30.5%, with 5.4% having possible severe PH. The primary potential predictors of PH severity are resting hypoxemia (low SatO2) and impaired diffusion capacity (low DLCO). These findings may suggest PH in this population is driven by the hypoxemia (gas exchange impairment) rather than airflow obstruction, potentially supporting PH screening in patients with these specific traits. A next phase of this project will include additional 338 patients, and the results will be published opportunely. Graph 1. Distribution of measured sPAP (N=92). This abstract is funded by: None
Scabello et al. (Fri,) conducted a cohort in Chronic Obstructive Pulmonary Disease (COPD) (n=167). Resting hypoxemia (r=-0.60, p<0.0001) and impaired diffusion capacity (r=-0.43, p=0.0187) were the primary predictors of elevated systolic pulmonary artery pressure in a cohort of COPD patients.