Pneumologie 2020; 74(S 01): 69
DOI: 10.1055/s-0039-3403210
Posterbegehung (PO11) – Sektion Klinische Pneumologie
Klinische Aspekte der COPD
Georg Thieme Verlag KG Stuttgart · New York

Pulmonary Hypertension in COPD: Is it worth looking for?

S Matthes
1   Institute of Pneumology and Allergology, Center of Sleep Medicine and Respiratory Care, Bethanien Hospital
,
C Priegnitz
2   Praxis Dr. Nothofer
,
M Treml
3   Institut für Pneumologie an der Universität zu Köln
,
N Anduleit
3   Institut für Pneumologie an der Universität zu Köln
,
K Richter
3   Institut für Pneumologie an der Universität zu Köln
,
I Kietzmann
3   Institut für Pneumologie an der Universität zu Köln
,
SD Herkenrath
4   Institut für Pneumologie an der Universität zu Köln, Krankenhaus Bethanien gGmbH, Klinik für Lungen- und Bronchialerkrankungen
,
L Hagmeyer
5   Klinik für Pneumologie und Allergologie, Krankenhaus Bethanien gGmbH
,
K Milger
6   Medizinische Klinik V, Comprehensive Pneumology Center (Cpc-M), Mitglied des Dzl, Klinikum der Universität München; Department of Internal Medicine V, Ludwig-Maximilians-University of Munich, Germany; Comprehensive Pneumology Center (Cpc-M), Member of the German Center for Lung Research (Dzl), Munich, Germany
,
WJ Randerath
7   Klinik für Pneumologie und Allergologie, Zentrum für Schlaf- und Beatmungsmedizin, Krankenhaus Bethanien GmbH, Solingen
› Author Affiliations
Further Information

Publication History

Publication Date:
28 February 2020 (online)

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    Background and Aim: Pulmonary hypertension (PH) is a known complication of chronic obstructive pulmonary disease (COPD) but is it worth screening for in the average hospitalized COPD patient? We examined prevalence, quality of life (QoL) and 5-year survival.

    Methods: We conducted a prospective, observational study of patients admitted with COPD at a university-affiliated respiratory hospital from September 2011 to September 2013. Lung function tests, NT-proBNP, echocardiography and right-heart catheter (RHC) were recorded. Patients completed 3 QoL questionnaires (SGRQ, CAMPHOR, SF-12). Patients were followed up in August 2019 for survival analysis.

    Results: 151 patients with COPD (FEV1 0.54 L ± 1.08) and 15 PH patients were recruited (90 female, age 65.6 ± 9.9). 4 groups were formed: COPD alone, COPD with echocardiographic suspicion of PH, COPD with confirmed PH (mean pulmonary artery pressure, mPAP, ≥ 25 mmHg at RHC), PH alone (control group). The prevalence of PH at echocardiography was 17.9% (27/151) and 7.9% (12/151) via RHC. The average mPAP was 37.67 ± 11.13 mmHg. Lower FEV1 did not predispose to PH (mean FEV1 in COPD without PH = 42.72 ± 18.79 Vs. 51.46 ± 20.91 in COPD with PH, p = 0.13), although severe hypoxemia did (p < 0.05) · QoL was reduced equally in all groups. Follow-up analysis of 110/161 patients (COPD n = 83, COPD with suspected PH n = 10, COPD with confirmed PH n = 9, PH alone n = 8) showed 60% overall survival at 5 years. There was no difference in the Kaplan-Meier 5-year survival curves between COPD patients with and without PH (p = 0.7).

    Conclusion: The presence of concomitant PH did not worsen the quality of life or negatively impact upon 5-year survival in this cohort of COPD patients. This data does not support the systematic screening of patients with COPD in order to identify the presence of PH.


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