From Lung News....I have pulmonary hypertension via echo and several co-morbidities. This is the first article I have found that actually utilized the pressure found during an echocardiogram. All the other articles use the right heart catheterization results.
"Researchers at the Cairo University in Egypt recently reported that patients
with chronic obstructive pulmonary disease (COPD) can also develop
co-morbidities as pulmonary hypertension and cardiac alterations. The study
was published in the Egyptian Journal of Chest Diseases and Tuberculosis and
is entitled "Detection of right sided heart changes and pulmonary
hypertension in COPD patients."
COPD is a common progressive disease in which individuals develop serious
breathing problems such as obstruction of the airways, shortness of breath
(dyspnea) and acute exacerbations. It is one of the most common lung
diseases and a major cause of morbidity and mortality worldwide. In the
United States, COPD is the third leading cause of death. Exacerbations and
co-morbidities contribute to COPD severity.
One common complication in COPD patients is pulmonary hypertension, which
corresponds to an increased pressure in the blood vessels that supply the
lungs; pulmonary hypertension is a life-threatening condition that can lead
to difficulties in breathing and right-sided heart failure. COPD-associated
pulmonary hypertension is considered a poor prognostic indicator, linked to
worse oxygenation and higher mortality. Right heart catheterization (RHC) is
a crucial diagnostic tool.
In this study, the function of the right-side of the heart along with the
diagnosis of pulmonary hypertension and hemodynamic abnormalities were
analyzed in order to assess functional limitations associated to pulmonary
hypertension on COPD patients. Information was collected between December
2012 and April 2013 from 51 COPD male patients. Data on echocardiogram exam,
PFT tests (post bronchodilators FEV1 ? 0.7), and BODE index (to assess the
body mass index) was recorded; only 17 patients underwent RHC because their
echo showed pulmonary artery systolic pressure ? 45 mmHg.
Researchers found that 11 out of the 51 patients had a mean pulmonary artery
pressure ? 25 mmHg indicating pulmonary hypertension and 2 patients had
severe pulmonary hypertension, with a mean pulmonary artery pressure ? 40
mmHg. Cardiovascular disease is known to be a common comorbidity in COPD
patients and in this study, 45% of the COPD patients with pulmonary
hypertension showed evidence of ischemic heart disease and 18% had
arrhythmias. In terms of right-side dimensions, the team found that 11
patients with pulmonary hypertension had a right ventricular enlargement in
comparison with patients without pulmonary hypertension. COPD patients with
pulmonary hypertension were also found to be more hypoxemic (reduced oxygen
content), have more severe airway obstruction and greater BODE index in
comparison with COPD patients without pulmonary hypertension. Concerning
diagnosis, the research team believes that an echocardiogram can be helpful,
but the results have to be interpreted cautiously and the ones who are
positive should be confirmed by RHC.
The authors concluded that pulmonary hypertension and right side changes are
common complications in COPD patients that affect survival and limit
exercise capacity. Of importance, COPD patients with pulmonary hypertension
are more prone to co-morbidities than patients with COPD alone. The research
team suggests that pulmonary hypertension screening in COPD patients is
essential as it can affect the prognosis - COPD patients with pulmonary
hypertension have a worse prognosis in comparison with COPD patients without
pulmonary hypertension.
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