Obstructive Lung Diseases |

The Effect of Pulmonary Hypertension on Cardiopulmonary Exercise Test in Severe COPD FREE TO VIEW

Wilawan Thirapatarapong*, MD; Hilary Armstrong, MA; Matthew Bartels, MD
Author and Funding Information

Columbia University, New York City, NY

Chest. 2012;142(4_MeetingAbstracts):737A. doi:10.1378/chest.1385602
Text Size: A A A
Published online


SESSION TYPE: COPD: Diagnosis and Evaluation

PRESENTED ON: Sunday, October 21, 2012 at 01:15 PM - 02:45 PM

PURPOSE: Pulmonary hypertension (PH) is common in patients with severe chronic obstructive pulmonary disease (COPD); however, its prevalence and effects on exercise tolerance and ventilatory efficiency remain unclear. The objectives of the present study were; (i) to determine the effects of PH on exercise capacity and gas exchange in patients with severe COPD and; (ii) to determine the variables that correlate to mean pulmonary artery pressure (mPAP).

METHODS: We retrospectively reviewed 152 patients with severe COPD who were referred to our center. Patients had complete data, including pulmonary function, right heart catheterization and cardiopulmonary exercise testing (CPET) done within 6 months of each other. PH was defined by a resting mPAP > 25 mmHg. Comparisons between COPD patients with and without PH were done by using the t-test and Mann-Whitney U test. Pearson correlation coefficient was used to assess the relationship between continuous variables. Statistical significance was set at p≤0.05.

RESULTS: 98 patients met inclusion criteria. PH was present in 31.6% of patients and most patients were mild (mPAP, 25-35 mmHg). Peak workload (Wattspeak%predicted: PH 15.1±8.5% vs without PH 21.1±15.4%) and oxygen uptake (VO2peak%predicted: PH 30.2±8.6% vs. without PH 36.3±14.6%) on CPET were significantly lower in COPD patients with PH. Mean PAP was found to inversely correlated with six-minute walk distance, VO2peak%predicted, and Wattspeak%predicted. No difference between two groups was seen in any of the ventilatory gas exchange parameters.

CONCLUSIONS: Pulmonary hypertension impairs exercise capacity but doesn’t significantly alter gas exchange in patients with severe COPD.

CLINICAL IMPLICATIONS: There appears to be a relatively high prevalence of PH in severe COPD which causes a decrease in exercise capacity in both CPET and six-minute walk test without changes in ventilatory efficiency. Lower than expected exercise performance in a patient with COPD may indicate a need for evaluation for possible PH.

DISCLOSURE: The following authors have nothing to disclose: Wilawan Thirapatarapong, Hilary Armstrong, Matthew Bartels

No Product/Research Disclosure Information

Columbia University, New York City, NY




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543