CHEST Guidelines-Pulmonary-Hypertension-in-Patients-With-COPD_2021

Pulmonary-Hypertension-in-Patients-With-COPD_2021_

Pdf Summary

The study focuses on pulmonary hypertension (PH) in patients with chronic obstructive pulmonary disease (COPD), analyzing data from the Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension (COMPERA). The research sought to determine which factors influence the outcomes of PH in COPD and compare these patients with those suffering from idiopathic pulmonary arterial hypertension (IPAH).<br /><br />Key findings indicate that patients with PH in COPD, while having similar hemodynamic impairments to IPAH patients, experienced worse functional capacity and survival rates. Specifically, transplant-free survival rates at 1, 3, and 5 years were significantly higher in the IPAH group compared to the PH in COPD group. Factors contributing to poor outcomes in PH in COPD included male sex, low 6-minute walking distance (6MWD), and high pulmonary vascular resistance (PVR).<br /><br />The study also highlights a notable subset of patients with severe PH in COPD who seemed to benefit from PH-targeted therapy, showing improvements in 6MWD by 30 meters or better World Health Organization functional class (WHO FC), linked to better survival outcomes. Despite these findings, it remains unclear if this improvement is due to PH therapy or other variables, pointing to the need for randomized controlled studies to explore the therapeutic benefits further.<br /><br />Overall, the study suggests that while PH-targeted therapy might aid certain patients with severe PH in COPD, further investigation through controlled trials is essential to confirm these potential benefits and to refine treatment protocols.

Keywords

pulmonary hypertension

chronic obstructive pulmonary disease

COMPERA

idiopathic pulmonary arterial hypertension

transplant-free survival

6-minute walking distance

pulmonary vascular resistance

PH-targeted therapy

WHO functional class

randomized controlled studies