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Pulmonary hypertension (PH) is a frequently observed complication of chronic obstructive pulmonary disease (COPD). While the PH associated with COPD is often mild in severity, 1% of these patients (pts) have severe PH. These pts often present with a downwardly spiraling clinical course due to the presence of both right heart failure and inadequate ventilation.
The study included 3,036 pts with a diagnosis of COPD from January 2000 to January 2011, who had a transthoracic echo done within 0 to 90 days from the diagnosis of COPD. The severity of PH was assessed by comparing pulmonary arterial systolic pressures (PASP). Only pts with an ejection fraction > 50 were included so as to exclude PH secondary to left heart failure. Pts were divided into 4 groups:
1) Group A: COPD with no PH (PASP < 35 mmHg)
2) Group B: COPD with mild PH (PASP 35-50 mmHg)
3) Group C: COPD with moderate PH (PASP 50-65 mmHg)
4) Group D: COPD with severe PH (PASP > 65 mmHg)
Records of inpatient deaths and social security death records were used to determine 1-year mortality.
The mean age was 73 ± 11 with 37% being male. 1-year death rates in groups A, B, C and D were 13%, 34%, 41% and 45% respectively (p<0.001 comparing groups B, C and D to Group A; p=0.001 comparing Group B vs. Group C; p=0.154 comparing Group C vs. Group D) [Figure 1].
There is a strong correlation between the severity of PH in pts with COPD and increased mortality. This suggests that the severity of PH may be a prognostic indicator in pts with COPD.
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Pulmonary Hypertension: Epidemiology, Prognosis, Outcomes
Abstract Category: 27. Pulmonary Hypertension
Presentation Number: 1251M-149
- 2013 American College of Cardiology Foundation