Borderline pulmonary hypertension associated with chronic hypercapnia in chronic pulmonary disease

Zuoyou, Liu; Shiota, Satomi; Morio, Yoshiteru; Sugiyama, Ai; Sekiya, Mitsuaki; Iwakami, Shin‐ichiro; Ienaga, Hiroki; Fukuchi, Yoshinosuke; Takahashi, Kazuhisa

doi:10.1016/j.resp.2019.01.003

Cited by 6 publications

(1 citation statement)

References 24 publications

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“…The relevance of BLPH in the survival of ILD patients from our cohort is consistent with preliminary data on the subject. In ILD, others have studied the relevance of BLPH, focusing on the impact of chronic hypercapnia [ 19 ] or on exercise capacity and the risk of exacerbation [ 20 ]. In the latter study, it was observed that in ILD, mPAP ≥21 mm Hg was associated with lower survival.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Borderline Pulmonary Hypertension on Survival in Chronic Lung Disease

et al. 2022

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Background: The impact of the new “borderline” hemodynamic class for pulmonary hypertension (PH) (mean pulmonary artery pressure [mPAP], 21–24 mm Hg and pulmonary vascular resistance, [PVR], ≥3 wood units, [WU]) in chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) is unclear. Objectives: The aim of this study was to assess the effect of borderline PH (BLPH) on survival in COPD and ILD patients. Method: Survival was analyzed from retrospective data from 317 patients in 12 centers (Italy, Spain, UK) comparing four hemodynamic groups: the absence of PH (NoPH; mPAP <21 mm Hg or 21–24 mm Hg and PVR <3 WU), BLPH (mPAP 21–24 mm Hg and PVR ≥3 WU), mild-moderate PH (MPH; mPAP 25–35 mm Hg and cardiac index [CI] ≥2 L/min/m2), and severe PH (SPH; mPAP ≥35 mm Hg or mPAP ≥25 mm Hg and CI <2 L/min/m2). Results: BLPH affected 14% of patients; hemodynamic severity did not predict survival when COPD and ILD patients were analyzed together. However, survival in the ILD cohort for any PH level was worse than in NoPH (3-year survival: NoPH 58%, BLPH 32%, MPH 28%, SPH 33%, p = 0.002). In the COPD cohort, only SPH had reduced survival compared to the other groups (3-year survival: NoPH 82%, BLPH 86%, MPH 87%, SPH 57%, p = 0.005). The mortality risk correlated significantly with mPAP in ILD (hazard ratio [HR]: 2.776, 95% CI: 2.057–3.748, p < 0.001) and notably less in COPD patients (HR: 1.015, 95% CI: 1.003–1.027, p = 0.0146). Conclusions: In ILD, any level of PH portends worse survival, while in COPD, only SPH presents a worse outcome.

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Section: Discussionmentioning

confidence: 99%