Clinical Characteristics Of Patients With Pulmonary Hypertension Associated With COPD

Objective To investigate the clinical characteristics of patients with pulmonary hypertension(PH) associated with chronic obstructive pulmonary disease(COPD), evaluate the value of pulmonary function test and chest computed tomography for predicting pulmonary hypertension.Methods Retrospective study of72patients with COPD, all patients were divided into three groups according to pulmonary artery systolic pressure(PASP) measured by echocardiography:control group(<35mmHg),mild PH group(35-50mmHg) and moderate-severe PH group(≥51mmHg), Smoking index, hematokrit, hemoglobin, D-Ⅱ polymer, blood-gas analysis, pulmonary function test, diameters of main pulmonary artery(MPA) and aorta were compared among the groups.Results The PaCO2of patients in moderate-severe PH group (64.32±15.24mmHg) was significantly higher than that of patients in control group (51.64± 13.43mmHg,p<0.05) and mild PH group (48.30±11.84mmHg,p<0.01). FVC, FEV1, FEV1/FVC, DLCO of patients were similar in mild PH group and moderate-severe PH group. The MPAD of patients in mild PH group (28.4±5.0mm) and moderate-severe PH group (30.0±2.8mm) were significantly bigger than control group(p<0.01). The ratio of main pulmonary artery to descending aorta diameter in two groups were significantly larger than control group.Conclusions The majority of PH in COPD is mild to moderate. There was no direct relationship between changes in pulmonary function (FEV1,FEV1/FVC,DLCO) and the severity of pulmonary hypertension in COPD patients, while the main pulmonary artery diameter and the ratio of main pulmonary artery to descending aorta diameter on CT scan show excellent diagnostic value, can be used to screen for PH associated with COPD.