Chest
Volume 127, Issue 5, May 2005, Pages 1480-1482
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Severe Pulmonary Hypertension in COPD: Is It a Distinct Disease?

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References (23)

  • ChaouatA et al.

    Severe pulmonary hypertension in chronic obstructive pulmonary disease [abstract]

    Am J Respir Crit Care Med

    (2003)
  • Cited by (47)

    • Hypoxia-induced pulmonary arterial hypertension augments lung injury and airway reactivity caused by ozone exposure

      2016, Toxicology and Applied Pharmacology
      Citation Excerpt :

      Based on the findings of the present study, we propose that pulmonary hypertension in COPD patients may be a crucial factor conferring vulnerability to environmental pollutants. Pulmonary hypertension in COPD patients can range from mild to severe (Ppa < 40 mm Hg) (Weitzenblum and Chaouat, 2005), and both prevalence and severity of pulmonary hypertension are associated with the severity of COPD. Most COPD patients exhibit mild-to-moderate increases in Ppa concomitant with decreases in lung function, but there are also a significant minority of COPD patients that exhibit more profound Ppa increases that may relate to arterial-alveolar oxygen gradients of simply other etiological causes of pulmonary hypertension (Thabut et al., 2005; Chaouat et al., 2008).

    • Pulmonary arterial lesions in explanted lungs after transplantation correlate with severity of pulmonary hypertension in chronic obstructive pulmonary disease

      2013, Journal of Heart and Lung Transplantation
      Citation Excerpt :

      The present study identified pulmonary vascular changes as an important component of COPD-related PH. Structural changes were observed prevalent at all stages of the disease and correlated with the degree of PH. In a small sub-set of patients with severe PH, in whom pulmonary pressures approached those characteristic of IPAH, vascular lesions were observed and included plexiform lesions, pulmonary hemosiderosis, and angiomatoid lesions. Several mechanisms are involved in the pathogenesis of PH in COPD, including hypoxia, dynamic pulmonary hyperinflation, parenchymal destruction, and to a variable extent, destruction of the vascular bed, pulmonary vascular remodeling, endothelial dysfunction, and inflammation.20,21 In lung transplant recipients with severe end-stage COPD, large areas of lung tissue will almost certainly be hypoxic, and it has been proposed that hypoxia contributes to vascular remodeling of the lungs in these patients.22

    • Diagnostic Dilemmas in Pulmonary Hypertension

      2012, Heart Failure Clinics
      Citation Excerpt :

      Other subsets may have genetic predispositions or associated connective tissue disease. The clinical dilemma is whether severe PH in this setting indicates a superimposed vasculopathy or is a consequence of the pulmonary process.70 If the former, therapy with pulmonary vascular targeted therapy may seem worth considering.

    • Mechanisms of pulmonary hypertension in chronic obstructive pulmonary disease: A pathophysiologic review

      2012, Journal of Heart and Lung Transplantation
      Citation Excerpt :

      Nevertheless, there is presently no clearly described phenotype nor data suggesting a specific therapeutic approach for managing PHT in this setting. Debate will continue as to whether out-of-proportion PHT is part of the normal spectrum of PHT-associated COPD, represents a distinct clinical phenotype, or reflects the coexistence of COPD and idiopathic pulmonary arterial hypertension.82,84 By way of comparison, among patients listed for lung transplantation with idiopathic pulmonary fibrosis the prevalence of PHT is 46.1%, of which 9.1% is considered severe (i.e., mPAP > 40 mm Hg).85

    • Prevalence, predictors, and survival in pulmonary hypertension related to end-stage chronic obstructive pulmonary disease

      2012, Journal of Heart and Lung Transplantation
      Citation Excerpt :

      Nevertheless, the benefits of therapy with specific pulmonary vasodilators remain questionable due to the detrimental effects on oxygenation observed when the hypoxic vasoconstriction response is inhibited.19,20 However, a sub-group that could potentially benefit from this treatment are patients with moderate lung function impairment despite the presence of severe PH.11,12,21 Previous studies have shown that PH in COPD patients is associated with increased mortality compared with patients with normal pulmonary pressures.6,22

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