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Abstract: Poster Presentations |

PREVALENCE AND IMPACT OF PULMONARY HYPERTENSION IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) LISTED FOR LUNG TRANSPLANTATION FREE TO VIEW

Michael J. Cuttica, MD*; Katrina Anderson; Christopher F. Barnett, MD; Oksana A. Shlobin, MD; Shahzad Ahmad, MD; Scott Barnett, MD; Roberto Machado, MD; Mark Gladwin, MD; Steven D. Nathan, MD
Author and Funding Information

National Institute of Health, Bethesda, MD


Chest


Chest. 2007;132(4_MeetingAbstracts):621a. doi:10.1378/chest.132.4_MeetingAbstracts.621a
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Abstract

PURPOSE: Pulmonary hypertension (PH) is common in advanced COPD with published incidences around 50% in the literature. PH is an important predictor of mortality in COPD. We attempted to characterize the prevalence of PH in a large cohort of patients with COPD listed for lung transplant.

METHODS: Retrospective review of the United Network for Organ Sharing (UNOS) database of patients listed for transplant due to COPD.

RESULTS: 1133 patients with the diagnosis of COPD were listed for transplant over a 10 year period (1997-2006). Of these 456 (40%) were found to have a mean pulmonary artery pressure (mPAP) of greater than 25mmHg at rest. The presence of PH seemed to correlate with an increased oxygen requirement; 44% of patients with PH required greater than 3 lpm as opposed to 35% of those without PH. PH also appeared to influence functional capacity as measured by the Six Minute Walk Test; 24.1% of patients with PH walked less than 500 ft versus 16.5% of those without PH. Of those patients with Very Severe (FEV1 <25%) and Severe (FEV1 25-34%) COPD, 41% and 35% respectively had mPAPs greater than 25mmHg, while in the Moderate (FEV1 35%+) COPD group 49% of patients had PH.

CONCLUSION: PH is common in patients with severe COPD listed for lung transplant and its presence seems to correlate with decreased functional capacity and increased oxygen needs. There is also a suggestion of a group of patients with relatively preserved lung function who have worse hemodynamics which may be contributing to their need for transplantation.

CLINICAL IMPLICATIONS: Identification of COPD patients with relatively well-preserved lung function but increased pulmonary artery pressures may represent a subgroup of patients in whom PAH therapy might be of benefit.

DISCLOSURE: Michael Cuttica, No Financial Disclosure Information; No Product/Research Disclosure Information

Wednesday, October 24, 2007

12:30 PM - 2:00 PM


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