Prevalence of pulmonary hypertension in COPD patients living at high altitude

IF 10.4 2区 医学 Q1 RESPIRATORY SYSTEM
C. Aguirre-Franco , CA. Torres-Duque , G. Salazar , A. Casas , C. Jaramillo , M. Gonzalez-Garcia
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Abstract

Background

Pulmonary hypertension (PH) is associated with poor prognosis for patients with chronic obstructive pulmonary disease (COPD). Most of the knowledge about PH in COPD has been generated at sea level, with limited information associated with high altitude (HA).

Objectives

To assess the prevalence and severity of PH in COPD patients living in a HA city (2,640 m).

Methods

Cross-sectional study in COPD patients with forced expiratory volume in the first second / forced vital capacity ratio (FEV1/FVC) post-bronchodilator <0,7. Transthoracic echocardiography (TTE), spirometry, carbon monoxide diffusing capacity, and arterial blood gasses tests were performed. Patients were classified according to the severity of airflow limitation. PH was defined by TTE as an estimated systolic pulmonary artery pressure (sPAP) > 36 mmHg or indirect PH signs; severe PH as sPAP > 60 mmHg; and disproportionate PH as an sPAP > 60 mmHg with non-severe airflow limitation (FEV1 > 50% predicted).

Results

We included 176 COPD patients. The overall estimated prevalence of PH was 56.3% and the likelihood of having PH increased according to airflow-limitation severity: mild (31.6%), moderate (54.9%), severe (59.6%) and very severe (77.8%) (p = 0.038). The PH was severe in 7.3% and disproportionate in 3.4% of patients.

Conclusions

The estimated prevalence of PH in patients with COPD at HA is high, particularly in patients with mild to moderate airflow limitation, and greater than that described for COPD patients at low altitude. These results suggest a higher risk of developing PH for COPD patients living at HA compared to COPD patients with similar airflow limitation living at low altitude.

生活在高海拔地区的慢性阻塞性肺疾病患者肺动脉高压的患病率。
背景:肺动脉高压(PH)与慢性阻塞性肺疾病(COPD)患者的不良预后有关。有关慢性阻塞性肺疾病(COPD)肺动脉高压的大部分知识都是在海平面上获得的,与高海拔地区(HA)相关的信息非常有限:评估居住在高海拔城市(海拔 2,640 米)的慢性阻塞性肺疾病患者 PH 的患病率和严重程度:方法:对第一秒用力呼气容积/用力生命容量比(FEV1/FVC)在支气管舒张后为 36 mmHg 或有间接 PH 征兆的慢性阻塞性肺病患者进行横断面研究;严重 PH 指 sPAP > 60 mmHg;不相称 PH 指 sPAP > 60 mmHg 但气流受限不严重(FEV1 > 50%预测值):我们共纳入了 176 名慢性阻塞性肺病患者。据估计,PH 的总患病率为 56.3%,根据气流受限严重程度的不同,PH 的患病率也有所上升:轻度(31.6%)、中度(54.9%)、重度(59.6%)和极重度(77.8%)(P = 0.038)。7.3%的患者PH值为重度,3.4%的患者PH值不成比例:结论:在高海拔地区的慢性阻塞性肺病患者中,尤其是轻度至中度气流受限的患者中,PH 的估计发病率较高,且高于低海拔地区慢性阻塞性肺病患者的发病率。这些结果表明,与生活在低海拔地区、气流受限程度相似的慢性阻塞性肺病患者相比,生活在医管局的慢性阻塞性肺病患者患 PH 的风险更高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Pulmonology
Pulmonology Medicine-Pulmonary and Respiratory Medicine
CiteScore
14.30
自引率
5.10%
发文量
159
审稿时长
19 days
期刊介绍: Pulmonology (previously Revista Portuguesa de Pneumologia) is the official journal of the Portuguese Society of Pulmonology (Sociedade Portuguesa de Pneumologia/SPP). The journal publishes 6 issues per year and focuses on respiratory system diseases in adults and clinical research. It accepts various types of articles including peer-reviewed original articles, review articles, editorials, and opinion articles. The journal is published in English and is freely accessible through its website, as well as Medline and other databases. It is indexed in Science Citation Index Expanded, Journal of Citation Reports, Index Medicus/MEDLINE, Scopus, and EMBASE/Excerpta Medica.
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