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The Proceedings of the American Thoracic Society 3:546 (2006)
© 2006 The American Thoracic Society
doi: 10.1513/pats.200603-050MS
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Pulmonary Hemodynamics in Patients with Chronic Obstructive Pulmonary Disease during Exercise and Exacerbation

Michiko Ito, Masayuki Hanaoka, Shintaro Kanda, Kazuhisa Urushihata, Tomonobu Koizumi, Keisaku Fujimoto and Keishi Kubo

First Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan

Correspondence and requests for reprints should be addressed to Masayuki Hanaoka, M.D., Ph.D., First Department of Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan. E-mail: masayuki{at}hsp.md.shinshu-u.ac.jp

It has been suggested that the severity of dyspnea and hypoxemia in patients with COPD either during exercise or in exacerbation status is related to the change of pulmonary hemodynamics. The pathophysiology of pulmonary circulation in such conditions, however, is not completely understood.

By right heart catheterization, the pulmonary hemodynamics was examined in 47 patients with COPD of stable status at rest and during bicycle ergometer exercise, and in 13 patients with COPD of exacerbation status. The lung function tests were performed in all patients. The correlations between pulmonary hemodynamics and lung functions were analyzed.

The mean pulmonary artery pressure (Formula) was mildly elevated in the patients of stable status at rest. The Formula, pulmonary artery wedge pressure (Pcwp), cardiac index (CI), and pulmonary vascular resistance index (PVRI) were significantly increased in the patients of stable status during exercise compared with those at rest. The increases in the Formula and Pcwp during exercise were correlated with the severity of airflow limitation. Meanwhile, the Formula and PVRI were slightly higher in the patients of exacerbation status than in those of stable status. However, the difference of the PVRI was not statistically significant. There were no significant differences of the CI and Pcwp between the patients of stable status and those of exacerbation status.

The pathophysiologies of pulmonary hypertension in patients with COPD during exercise and exacerbation are different. During exercise the magnitude of the Formula increase is correlated with the severity of airflow limitation, which strongly suggests that the pulmonary hypertension is associated with dynamic hyperinflation.

FOOTNOTES

Conflict of Interest Statement: None of the authors has a financial relationship with a commercial entity that has an interest in the subject of this manuscript.

(Received in original form March 16, 2006; accepted in final form March 21, 2006)





This Article
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