Theme: advanced lung diseasePrevalence, predictors, and survival in pulmonary hypertension related to end-stage chronic obstructive pulmonary disease
Section snippets
Study population
This was a retrospective study of a consecutive cohort of COPD/emphysema and α-1-antitrypsin–deficient patients who underwent evaluation for lung transplantation at the National University Hospital, Rigshospitalet, Denmark, from January 1991 to January 2010. Patients were primarily identified from the ScandiaTransplant Registry, a Nordic registry that lists patients for transplantation. The study also included patients who had been evaluated but not listed for lung transplantation.
The
Results
Of 562 potential candidates for inclusion, 65 were excluded: 16 because of concomitant pulmonary fibrotic restrictive diseases, 41 because of absence of the entire pre-transplant evaluation data set and 8 due to various other reasons, leaving 497 patients eligible for inclusion. A further 88 patients were excluded due to the absence of RHC data, resulting in a study population of 409 patients (Figure 1). Of these, 277 patients (68%) underwent lung transplantation, and 132 (32%) were evaluated
Discussion
The present study identified PH in 36% of patients with end-stage COPD who were evaluated for pulmonary transplantation. Hypoxemia and hypercapnia were identified as significant predictors of mPAP, whereas demographics, lung function, and functional parameters showed no relation to pulmonary pressures. PH in end-stage COPD was associated with increased mortality, but does not influence the prognosis after lung transplantation.
Disclosure statement
The study received grant support from the Jacob & Olga Madsens Foundation and the Heart-Center Research Foundation, Copenhagen, Denmark.
None of the authors has a financial relationship with a commercial entity that has an interest in the subject of the presented manuscript or other conflicts of interest to disclose.
References (26)
- et al.
Impact of pulmonary artery pressure on exercise function in severe COPD
Chest
(2009) - et al.
Categorization and impact of pulmonary hypertension in patients with advanced COPD
Respir Med
(2010) - et al.
International guidelines for the selection of lung transplant candidates: 2006 update—a consensus report from the Pulmonary Scientific Council of the International Society for Heart and Lung Transplantation
J Heart Lung Transplant
(2006) - et al.
Pulmonary hemodynamics in advanced COPD candidates for lung volume reduction surgery or lung transplantation
Chest
(2005) - et al.
Severe pulmonary hypertension in COPD: is it a distinct disease?
Chest
(2005) - et al.
Prognostic factors in COPD patients receiving long-term oxygen therapyImportance of pulmonary artery pressure
Chest
(1995) - et al.
Worldwide burden of COPD in high- and low-income countriesPart I. The burden of obstructive lung disease (BOLD) initiative
Int J Tuberc Lung Dis
(2008) - et al.
Guidelines for the diagnosis and treatment of pulmonary hypertension: The Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT)
Eur Heart J
(2009) - et al.
Pulmonary hypertension in COPD: epidemiology, significance, and management: pulmonary vascular disease: the global perspective
Chest
(2010) Chronic cor pulmonale
Heart
(2003)
Single-breath carbon monoxide diffusing capacity (transfer factor)Recommendations for a standard technique—1995 update
Am J Respir Crit Care Med
[Lung volumes and forced ventilatory flows. Work Group on Standardization of Respiratory Function Tests. European Community for Coal and Steel. Official position of the European Respiratory Society]
Rev Mal Respir
Standardization of the measurement of transfer factor (diffusing capacity)Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official statement of the European Respiratory Society
Eur Respir J Suppl
Cited by (189)
Compartment-specific remodeling patterns in end-stage chronic obstructive pulmonary disease with and without severe pulmonary hypertension
2024, Journal of Heart and Lung Transplantation