The prevalence of pulmonary hypertension increased significantly with COPD severity, affecting 31.0% of GOLD 2, 39.3% of GOLD 3, and 69.2% of GOLD 4 patients (p=0.01).
Cross-Sectional (n=70)
Does the prevalence and severity of pulmonary hypertension correlate with the severity of airflow obstruction in patients with COPD?
Pulmonary hypertension is highly prevalent in COPD patients, affecting over 40% overall and nearly 70% of those with very severe (GOLD 4) disease, warranting echocardiographic screening.
p-value: p=0.01
Abstract Rationale Pulmonary hypertension (PH) is a common comorbidity in COPD associated with increased mortality and hospitalizations. Echocardiography is a primary noninvasive screening tool. We aimed to determine the prevalence of PH and correlate the mean pulmonary artery systolic pressure (PASP) with the severity of airflow obstruction as defined by GOLD guidelines. Methods We conducted a cross-sectional study of 70 patients with spirometry-confirmed COPD (post-BD FEV1/FVC 0.7). Severity was staged using post-bronchodilator FEV1% per GOLD 2023. PASP was estimated by transthoracic echocardiography. PH was defined as PASP 30 mmHg, and further classified as mild (30-50), moderate (50-70), or severe (70 mmHg). Statistical analysis used ANOVA and Fisher’s exact test. Results 70 patients (mean age 62.3, 74.3% male) were studied, comprising 29 (41.4%) GOLD 2, 28 (40.0%) GOLD 3, and 13 (18.6%) GOLD 4 patients. Overall, 41.4% of patients had PH (PASP 30 mmHg). The prevalence of PH increased significantly with COPD severity: 31.0% of GOLD 2 patients had PH, compared to 39.3% of GOLD 3 and 69.2% of GOLD 4 (p = 0.01). Mean PASP also rose significantly with increasing severity: 26.0 ± 7.6 mmHg (GOLD 2), 27.6 ± 8.4 mmHg (GOLD 3), and 47.4 ± 21.0 mmHg (GOLD 4) (p 0.0001). Moderate (PASP 50-70 mmHg) and severe (PASP 70 mmHg) PH were almost exclusively seen in the GOLD 4 group, with prevalence of 23.1% and 15.4%, respectively Conclusion Pulmonary hypertension is highly prevalent in patients with moderate to very severe COPD, affecting over 40% of this cohort and rising to nearly 70% in those with very severe (GOLD 4) disease. Echocardiographic screening for PH is strongly warranted in patients with severe airflow obstruction for cardiovascular risk stratification. This abstract is funded by: No funding required
Shah et al. (Fri,) conducted a cross-sectional in COPD (n=70). The prevalence of pulmonary hypertension increased significantly with COPD severity, affecting 31.0% of GOLD 2, 39.3% of GOLD 3, and 69.2% of GOLD 4 patients (p=0.01).