Post Exercise Desaturation Can Help Identifying Treatment Responders of COPD Pulmonary Hypertension in Real World: An Appraisal

Abstract

Background: COPD associated pulmonary hypertension (COPD-PH) leads to desaturation on exercise. It affects the health status and survival adversely. Objective: To look for the change in pulse rate, arterial oxygen saturation (SpO2), and the health status on treatment of COPD-PH with sildenafil administered on a desaturation criteria in response to a simple exercise protocol. Methods: Patients of COPD-PH (diagnosed clinic-radio-echocardiographically) were subjected to a simple and uniform exercise test involving sitting and moving between two chairs (2 chair test). The baseline and post exercise measurement of the pulse rate and SpO2 at every 10 seconds were recorded for 120 seconds. Patients showing a desaturation ≥ 3% ware prescribed PH-specific pharmacotherapy as sildenafil. Change in resting pulse rate, SpO2, and COPD assessment test (CAT score) were noted and compared after 90 ± 15 days of observation with or without sildenafil. Results: Out of 147 COPD patients, 89 (60.5%) had PH of which 62 subject qualified for sildenafil. At the end of follow up 57 and 27 subjects (with or without receiving sildenafil) were available for statistical calculation. Both the group of patients were similar in age, FEV1, FVC, and FEV1/FVC. The treated group showed an improvement in CAT (P<0.0001) and saturation (p=0.0003) while those on COPD therapy alone had mild worsening in arterial oxygen saturation (p=0.03). Inference: Patients of COPD-PH treated on the basis of exercise desaturation showed significant improvement to PH specific pharmacotherapy. The observation demands attention and validation to define the indication of PH specific pharmacotherapy in COPD-PH. *Corresponding author: Parthasarathi Bhattacharyya, Institute of Pulmocare and Research, Kolkata, India, Tel: 9165481305; E-mail: parthachest@yahoo.com Received July 06, 2018; Accepted August 31, 2018; Published September 07, 2018 Citation: Bhattacharyya P, Sengupta S, Bhattacharjee PD, Ganguly D, Dutta D, et al. (2018) Post Exercise Desaturation Can Help Identifying Treatment Responders of COPD Pulmonary Hypertension in Real World: An Appraisal. J Pulm Respir Med 8: 469. doi: 10.4172/2161-105X.1000469 Copyright: ©2018 Bhattacharyya P, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.