The contribution of left heart disease in COPD patients with pulmonary hypertension

Lepida, Dimitra; Παπαθανασίου, Αθανάσιος; Galiatsou, Eftychia; Nakos, George; Goudevenos, Ioannis; Koulouras, Vasilios

doi:10.1016/j.hjc.2018.02.001

Cited by 12 publications

(6 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Notably, HFpEF has been discernible across all patients with confirmed pulmonary hypertension via right heart catheterization (RHC). These findings underscore the predominant role of left heart failure in precipitating pulmonary hypertension among patients with respiratory diseases and offer insights into the presence of severe pulmonary hypertension in some patients [60].…”

Section: Comorbidity and Pulmonary Arterial Hypertensionmentioning

confidence: 54%

Pulmonary vascular disease in chronic lung diseases: cause or comorbidity?

Blanco,

Torres-Castro,

Barberà

2024

Current Opinion in Pulmonary Medicine

View full text Add to dashboard Cite

Purpose of review To provide timely and relevant insights into the complex relationship between pulmonary vascular disease (PVD) and chronic lung disease (CLD), focusing on the causative and consequential dynamics between these conditions. Recent findings There are shared pathogenic mechanisms between pulmonary arterial hypertension (PAH) and group 3 pulmonary hypertension, including altered expression of mediators and growth factors implicated in both conditions. Factors such as hypoxia, hypoxemia, and hypercapnia also contribute to pulmonary vascular remodelling and endothelial dysfunction. However, the role of hypoxia as the sole driver of pulmonary hypertension in CLD is being reconsidered, particularly in chronic obstructive pulmonary disease (COPD), with evidence suggesting a potential role for cigarette smoke products in initiating pulmonary vascular impairment. On the other hand, interstitial lung disease (ILD) encompasses a group of heterogeneous lung disorders characterized by inflammation and fibrosis of the interstitium, leading to impaired gas exchange and progressive respiratory decline, which could also play a role as a cause of pulmonary hypertension. Summary Understanding the intricate interplay between the pulmonary vascular compartment and the parenchymal and airway compartments in respiratory disease is crucial for developing effective diagnostic and therapeutic strategies for patients with PVD and CLD, with implications for both clinical practice and research.

show abstract

Section: Comorbidity and Pulmonary Arterial Hypertensionmentioning

confidence: 54%

Pulmonary vascular disease in chronic lung diseases: cause or comorbidity?

Blanco,

Torres-Castro,

Barberà

2024

Current Opinion in Pulmonary Medicine

View full text Add to dashboard Cite

show abstract

“…More importantly, it may help to detect other frequently associated cardiac pathologies, such as left ventricle and valve dysfunctions, which can cause group 2 PHT. For example, in their study, Lepida et al found that PHT was not only a consequence in patients with COPD, but it might also originate from the presence of left heart dysfunction (LHD) in up to 30% of the patients 18 . There are some studies investigating the value of the SX window in the evaluation of PHT and right heart function in COPD patients in outpatient settings.…”

Section: Discussionmentioning

confidence: 99%

The usefulness of subxiphoid view in the evaluation of acceleration time and pulmonary hypertension in ICU patients

et al. 2020

View full text Add to dashboard Cite

Background Pulmonary hypertension (PHT) is very frequent in ICUs. Estimation of systolic pulmonary artery pressure (PASP) by using tricuspid regurgitation velocity (TRV) is impossible in 25% of patients. However, it may be possible to estimate PHT in these patients by obtaining subxiphoid imaging of short axis (SX‐SAX) and measuring pulmonary artery diameter (PAD) and right ventricular outflow tract (RVOT) acceleration time (AT). We first aimed to compare the values of AT and PAD measured at the parasternal short axis view (PSAX) and SX‐SAX and then to compare AT measurements obtained in the RVOT and pulmonary artery (PA) in ICU patients. Methods This prospective observational study was conducted in a 7‐bed ICU of a tertiary academic teaching hospital. Measurements of TRV, PAD, and AT in parasternal and subxiphoid SAX were obtained. AT was measured in RVOT and PA locations. We measured other echocardiographic signs of PHT to assess the probability of PHT in addition to TRV measurements. Results The study consisted of 61 patients. TRV was measured in 85% of the patients, and SX‐SAX was visualized in 78%. The probability of PHT was high (49%) in this study population. There were agreement and no proportional bias between the measurements of PAD and AT at both SX‐SAX and PSAX. Measurements of AT in the RVOT and PA were similar, as well. Conclusion These results suggested that measurements of AT in the PSAX and SX‐SAX and RVOT and PA were similar in the ICU patients.

show abstract

“…A hallmark of cardiovascular disease is pulmonary arterial stiffness, which is increased in CLD compared with healthy controls [46] and particularly prominent in COPD, wherein it is also found in systemic arteries when patients develop PH [47]. Postcapillary PH (Group 2 PH, with normal PVR) is frequent in CLD (5–20% of ILD [48,49 ▪ ] and 12–62% of COPD [50–52] patients, depending on the population considered) and has great impact on morbidity and mortality [49 ▪ ,50,53]. Its prevalence may be underestimated, because the distinction between pre and postcapillary PH requires RHC, not indicated in most patients with CLD.…”

Section: Comorbidities and Effects Of The Underlying Lung Diseasementioning

confidence: 99%

Pulmonary hypertension in interstitial lung disease and in chronic obstructive pulmonary disease: different entities?

Piccari

Aguilar-Colindres

Rodríguez-Chiaradia

2023

Current Opinion in Pulmonary Medicine

View full text Add to dashboard Cite

Purpose of review Pulmonary hypertension (PH) is a common complication of both chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD), classified as Group 3 PH. To which extent PH presents and behaves similarly in COPD and ILD is unclear. This review examines the similarities and differences in pathogenesis, clinical presentation, natural history and treatment response of PH in COPD and ILD. Recent findings The latest studies on PH in chronic lung disease have re-evaluated the role of traditionally held etiopathogenetic factors such as tobacco exposure and hypoxia, although new ones such as airborne pollutant and genetic mutations are increasingly recognized. We examine common and diverging factors involved in PH development in COPD and ILD, as well as common and diverging clinical features of presentation, natural history and response to treatment and highlight areas for future research. Summary The development of PH in lung disease significantly worsens the morbidity and mortality of patients with COPD and ILD. However, recent findings show importance of recognizing distinct patterns and behaviors of pulmonary vascular disease, taking into account the specific underlying lung disease and severity of the hemodynamic involvement. Further studies are needed to build evidence on these aspects, especially in early disease.

show abstract

The contribution of left heart disease in COPD patients with pulmonary hypertension

Abstract: The use of echocardiographic criteria for the presence of PH is adequate for the screening of COPD patients. Patients with acute exacerbation of COPD and possible/likely PH demonstrate worse mortality compared to patients unlikely to have PH.

Cited by 12 publications

References 21 publications

Pulmonary vascular disease in chronic lung diseases: cause or comorbidity?

Pulmonary vascular disease in chronic lung diseases: cause or comorbidity?

The usefulness of subxiphoid view in the evaluation of acceleration time and pulmonary hypertension in ICU patients

Pulmonary hypertension in interstitial lung disease and in chronic obstructive pulmonary disease: different entities?

Contact Info

Product

Resources

About