Long-Term Oxygen Therapy Can Reverse the Progression of Pulmonary Hypertension in Patients with Chronic Obstructive Pulmonary Disease

Weitzenblum, E; Sautegeau, A.; Ehrhart, M; Mammosser, M; Pelletier, Antoine

doi:10.1164/arrd.1985.131.4.493

Cited by 376 publications

(157 citation statements)

References 14 publications

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“…Yet, mean PAP is a good predictor of exercise capacity [15], [61] and a better prognostic factor than the forced expiratory volume in the first second (FEV 1 ) or the degrees of hypoxemia or hypercapnia in COPD patients [62]. Over time, PH secondary to COPD tends to progress with a reported rise in mean PAP of 0.5–1.5 mmHg per year [63], [64], and may ultimately cause exercise intolerance [65], [66], right ventricular dysfunction [67] and thus, potentially contribute to patient mortality in COPD [68]. While it is tempting to hypothesize that these associations of PH with clinical outcome may reflect a significant clinical relevance of PH in COPD, recent clinical trials targeting the pulmonary vasculature in patients with COPD and PH seemingly point to the contrary.…”

Section: Discussionmentioning

confidence: 99%

Vasodilatory Effect of the Stable Vasoactive Intestinal Peptide Analog RO 25-1553 in Murine and Rat Lungs

et al. 2013

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RationaleStable analogs of vasoactive intestinal peptide (VIP) have been proposed as novel line of therapy in chronic obstructive pulmonary disease (COPD) based on their bronchodilatory and anti-inflammatory effects. We speculated that VIP analogs may provide additional benefits in that they exert vasodilatory properties in the lung, and tested this hypothesis in both ex vivo and in vivo models.MethodsIn isolated perfused mouse lungs and in an in vivo rat model, pulmonary blood vessels were preconstricted by hypoxia and hemodynamic changes in response to systemic (ex vivo) or inhaled (in vivo) administration of the cyclic VIP analog RO 25-1553 were determined.ResultsIn mouse lungs, RO 25-1553 reduced intrinsic vascular resistance at normoxia, and attenuated the increase in pulmonary artery pressure in response to acute hypoxia. Consistently, inhalation of RO 25-1553 (1 mg·mL−1 for 3 min) caused an extensive and sustained (> 60 min) inhibition of the pulmonary arterial pressure increase in response to hypoxia in vivo that was comparable to the effects of inhaled sildenafil. This effect was not attributable to systemic cardiovascular effects of RO 25-1553, but to a lung specific reduction in pulmonary vascular resistance, while cardiac output and systemic arterial hemodynamics remained unaffected. No adverse effects of RO 25-1553 inhalation on pulmonary gas exchange, ventilation-perfusion matching, or lung fluid content were detected.ConclusionOur findings demonstrate that inhaled delivery of the stable VIP analog RO 25-1553 induces a potent and sustained vasodilatory effect in the pulmonary circulation with no detectable adverse effects. Therapeutic inhalation of RO 25-1553 may provide vascular benefits in addition to its reported anti-inflammatory and bronchodilatory effects in COPD, yet caution is warranted given the overall poor results of vasodilator therapies for pulmonary hypertension secondary to COPD in a series of recent clinical trials.

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Section: Discussionmentioning

confidence: 99%

Vasodilatory Effect of the Stable Vasoactive Intestinal Peptide Analog RO 25-1553 in Murine and Rat Lungs

et al. 2013

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“…These studies illustrate that PH in COPD progresses slowly and occurs in mild as well as severe forms of disease. [2021]…”

Section: Discussionmentioning

confidence: 99%

Echocardiographic evaluation of heart in chronic obstructive pulmonary disease patient and its co-relation with the severity of disease

et al. 2011

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Background:Chronic obstructive pulmonary disease (COPD) has considerable effects on cardiac functions, including those of the right ventricle, left ventricle, and pulmonary blood vessels. Most of the increased mortality associated with COPD is due to cardiac involvement. Echocardiography provides a rapid, noninvasive, portable, and accurate method to evaluate the cardiac changes.Aims:To assess the cardiac changes secondary to COPD by echocardiography and to find out the correlation between echocardiographic findings and severity of COPD, if there is any.Materials and Methods:A total 40 of patients of COPD were selected and staged by pulmonary function test (PFT) and evaluated byechocardiography.Results:On echocardiographic evaluation of COPD, 50% cases had normal echocardiographic parameters. Measurable tricuspid regurgitation (TR) was observed in 27/40 cases (67.5%). Pulmonary hypertension (PH), which is defined as systolic pulmonary arterial pressure (sPAP)> 30 mmHg was observed in 17/27 (63%) cases in which prevalence of mild, moderate, and severe PH were 10/17 (58.82%), 4/17 (23.53%), and 3/17 (17.65%), respectively. The frequencies of PH in mild, moderate, severe, and very severe COPD were 16.67%, 54.55%, 60.00%, and 83.33%, respectively. Right atrial pressure was 10 mmHg in 82.5% cases and 15 mmHg in 17.5% cases. Cor pulmonale was observed in 7/17 (41.17%) cases; 7.50% cases had left ventricle (LV) systolic dysfunction and 47.5% cases had evidence of LV diastolic dysfunction defined as A ≥ E (peak mitral flow velocity of the early rapid filling wave (E), peak velocity of the late filling wave caused by atrial contraction (A) on mitral valve tracing) Left ventricle hypertrophy was found in 22.5% cases.Conclusion:Prevalence of PH has a linear relationship with severity of COPD and severe PH is almost associated with cor pulmonale. Echocardiography helps in early detection of cardiac complications in COPD cases giving time for early interventions.

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“…The use of oxygen (O 2 ) to treat respiratory failure in patients with COPD and long-term oxygen therapy have been studied since the 1980s [5]. Several other therapeutic strategies have also been used for adjuvant therapy in COPD.…”

Section: Introductionmentioning

confidence: 99%

Heliox-Driven Nebulization Has a Positive Effect on the Lung Function in Lipopolysaccharide-Induced Chronic Obstructive Pulmonary Disease Rat Model

Chen

Liu

et al. 2016

Med Sci Monit

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BackgroundChronic obstructive pulmonary disease (COPD) is a serious lung disease that severely threatens people’s health. This study aimed to investigate the effects of heliox-driven nebulization (HDN) on lung function and arterial blood gases in a COPD rat model.Material/MethodsTwelve healthy male Wistar rats were selected as controls and 34 rats were used to establish a COPD model induced by lipopolysaccharide. Then 6 rats each from the control and model groups were selected for their symptoms to be observed. The remaining 6 normal rats were used as control group (group A) and the remaining 28 experimental COPD rats were randomly assigned to 4 groups: experimental COPD group (group B), medical oxygen group (group C), and heliox groups (group D, He/O2=63%/37%; group E, He/O2=71%/29%). The lung function indicators and arterial blood gases were analyzed to evaluate the effects of different driving gases on COPD rats.ResultsThe COPD model was successfully established with slow growth and severe lung dysfunction. Inspiratory resistance, expiratory resistance, and forced expiratory volume at 0.10 s (FEV0.10)/FVC were significantly decreased, whereas dynamic lung compliance was significantly increased in groups D and E, compared with the experimental COPD group (group B; P<0.05). Meanwhile, compared with the model group, the values of partial pressure of carbon dioxide in arterial blood were significantly higher, whereas the potential of hydrogen values were significantly lower after atomization in groups C and D but not in group E (P<0.05). The obvious increase in arterial oxygen saturation was found only in group E (P<0.05).ConclusionsHDN improved the lung function and arterial blood gas analysis results in experimental COPD rats, with an optimal percentage of He/O2=71%/29%.

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Long-Term Oxygen Therapy Can Reverse the Progression of Pulmonary Hypertension in Patients with Chronic Obstructive Pulmonary Disease

Cited by 376 publications

References 14 publications

Vasodilatory Effect of the Stable Vasoactive Intestinal Peptide Analog RO 25-1553 in Murine and Rat Lungs

Vasodilatory Effect of the Stable Vasoactive Intestinal Peptide Analog RO 25-1553 in Murine and Rat Lungs

Echocardiographic evaluation of heart in chronic obstructive pulmonary disease patient and its co-relation with the severity of disease

Heliox-Driven Nebulization Has a Positive Effect on the Lung Function in Lipopolysaccharide-Induced Chronic Obstructive Pulmonary Disease Rat Model

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