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Chest. 2005 May;127(5):1531-6.

Pulmonary hemodynamics in advanced COPD candidates for lung volume reduction surgery or lung transplantation.

Author information

1
Service de Pneumologie et Réanimation Respiratoire, Hôpital Beaujon, 100 B du Général Leclerc 92110, Clichy, France.

Abstract

STUDY OBJECTIVES:

To assess the pulmonary hemodynamic characteristics in COPD candidates for lung volume reduction surgery (LVRS) or lung transplantation (LT).

DESIGN:

Retrospective study.

SETTING:

One center in France.

PATIENTS:

Two hundred fifteen patients with severe COPD who underwent right-heart catheterization before LVRS or LT.

RESULTS:

Mean age was 54.6 years. Pulmonary function test results were as follows: FEV(1), 24.3% predicted; total lung capacity, 128.3% predicted; residual volume, 259.7% predicted. Mean pulmonary artery pressure (PAPm) was 26.9 mm Hg. Pulmonary hypertension (PAPm > 25 mm Hg) was present in 50.2% and was moderate (PAPm, 35 to 45 mm Hg) or severe (PAPm > 45 mm Hg) in 9.8% and in 3.7% of patients, respectively. Cardiac index was low normal. PAPm was related to Pao(2) and alveolar-arterial oxygen gradient in multivariate analysis. Cluster analysis identified a subgroup of atypical patients (n = 16, 7.4%) characterized by moderate impairment of the pulmonary mechanics (mean FEV(1), 48.5%) contrasting with high level of pulmonary artery pressure (PAPm, 39.8 mm Hg), and severe hypoxemia (mean Pao(2), 46.2 mm Hg).

CONCLUSION:

While pulmonary hypertension is observed in half of the COPD patients with advanced disease, moderate-to-severe pulmonary hypertension is not a rare event in these patients. We individualized a subgroup of patients presenting with a predominant vascular disease that could potentially benefit from vasodilators.

PMID:
15888824
DOI:
10.1378/chest.127.5.1531
[Indexed for MEDLINE]

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