Chronic obstructive pulmonary disease and pulmonary hypertension: clinical course, survival and mortality predictors
https://doi.org/10.18093/0869-0189-2017-27-3-357-365
Abstract
The aim of this study was to investigate clinical course, survival and predictors of mortality in patients with chronic obstructive pulmonary disease (COPD) with or without pulmonary hypertension (PH). Methods. The study involved 288 patients with COPD (276 males, 12 females; mean age, 59.50 ± 9.27 years; smoking history, 23.10 ± 11.42 pack-years; body mass index, 27.20 ± 12.06 kg × m-2; the annual exacerbation rate, 2.40 ± 0.89), GOLD stage, II – IV (GOLD, 2016). PH was diagnosed if resting systolic pulmonary artery pressure (sysPAP) measured by Doppler echocardiography was > 40 mm Hg. The patients were divided on three groups: those without PH (sysPAP < 40 mm Hg; n = 168), those with moderate PH (sysPAP, 40 – 55 mm Hg; n = 101), and those with severe PH (sysPAP > 55 mm Hg; n = 19). Results. Increased sysPAP was found in 120 patients (41.7%) including 101 patients with moderate PH (35.1%) and 19 patients with severe PH (6.6%). Clinical symptoms of PH were more prominent in COPD patients with severe PH. Clinical symptoms assessed by CAT and Borg's scales, COPD exacerbation rate, the right atrium size, sysPAP, blood levels of C-reactive protein, fibrinogen, NT-proCNP and NT-proBNP predicted mortality of patients with COPD and PH. Survival of COPD patients with PH depended on PH severity. Conclusion. In most patients with COPD and PH, PH was moderate. PH aggravated severity of clinical signs and symptoms and increased the risk of mortality. In-hospital survival of patients with COPD and PH depended on PH severity.
About the Authors
Viliya V. Gaynitdinova
Bashkir Federal State Medical University, Healthcare Ministry of Russia
Russian Federation
Doctor of Medicine, Associate Professor at Department of Therapy and Clinical Pharmacology, Bashkir State Medical University; tel.: (347) 272-23-85;
Competing Interests: There is no conflict of interest. The study was performed without any sponsorship.
Russian Federation
Doctor of Medicine, Associate Professor at Department of Therapy and Clinical Pharmacology, Bashkir State Medical University; tel.: (347) 272-23-85;
Competing Interests: There is no conflict of interest. The study was performed without any sponsorship.
Sergey N. Avdeev
Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia
Russian Federation
Doctor of Medicine, Professor, Corresponding Member of Russian Academy of Sciences, Head of Clinical Division, Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; tel.: (495) 465-52-64;
Competing Interests: There is no conflict of interest. The study was performed without any sponsorship.
Russian Federation
Doctor of Medicine, Professor, Corresponding Member of Russian Academy of Sciences, Head of Clinical Division, Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; tel.: (495) 465-52-64;
Competing Interests: There is no conflict of interest. The study was performed without any sponsorship.
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Gaynitdinova V.V., Avdeev S.N. Chronic obstructive pulmonary disease and pulmonary hypertension: clinical course, survival and mortality predictors. PULMONOLOGIYA. 2017;27(3):357-365. (In Russ.) https://doi.org/10.18093/0869-0189-2017-27-3-357-365
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