Frequency of Pulmonary Hypertension in Patients with Chronic Obstructive Pulmonary Disease
DOI:
https://doi.org/10.70749/ijbr.v3i7.1942Keywords:
COPD, Pulmonary Hypertension, Echocardiography, Diabetes Mellitus, SmokingAbstract
Introduction: Chronic obstructive pulmonary disease (COPD) is frequently associated with pulmonary hypertension, which significantly impacts patient outcomes. This study aimed to determine the frequency of pulmonary hypertension in patients with COPD. Methodology: This descriptive cross-sectional study was conducted at the Department of Pulmonology, Liaquat National Hospital, Karachi. A total of 162 COPD patients aged 18-80 years were enrolled using non-probability consecutive sampling. Pulmonary hypertension was diagnosed via echocardiography when pulmonary artery systolic pressure was >35 mmHg and tricuspid regurgitant velocity was >3.4. Data was analyzed using SPSS v25.0. Results: Among 162 patients, 92 (56.8%) were males and 70 (43.2%) were females with a mean age of 46.17±14.27 years. Pulmonary hypertension was found in 44 (27.2%) patients. Significant associations were observed between pulmonary hypertension and diabetes mellitus (p=0.001), smoking (p=0.001), and COPD duration (p=0.001). No significant associations were found with gender, age groups, or BMI categories. Conclusion: Pulmonary hypertension was present in more than one-fourth of COPD patients. Diabetes mellitus, smoking history, and longer COPD duration were significantly associated with the development of pulmonary hypertension in these patients.
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References
1. Rashid, M. H. (2019). Electrolyte disturbances in acute exacerbation of COPD. Journal of Enam Medical College, 9(1), 25-29.
https://doi.org/10.3329/jemc.v9i1.39900
2. Ouf, M., Ahmed, F., Ahmed, H., Ahmed, E., & Mohammed, A. (2015). Electrolytes disturbances and their impact on mechanically ventilated patients with acute exacerbation of chronic obstructive pulmonary disease. Al-Azhar Assiut Med J, 3, 27-34.
3. Kutz, A., Ebrahimi, F., Aghlmandi, S., Wagner, U., Bromley, M., Illigens, B., Siepmann, T., Schuetz, P., Mueller, B., & Christ-Crain, M. (2020). Risk of adverse clinical outcomes in Hyponatremic adult patients hospitalized for acute medical conditions: A population-based cohort study. The Journal of Clinical Endocrinology & Metabolism, 105(11), 3428-3436.
https://doi.org/10.1210/clinem/dgaa547
4. Zhang, X., & Xu, D. (2020). Effects of exercise rehabilitation training on patients with pulmonary hypertension. Pulmonary Circulation, 10(3), 1-8.
https://doi.org/10.1177/2045894020937129
5. Simonneau, G., Montani, D., Celermajer, D. S., Denton, C. P., Gatzoulis, M. A., Krowka, M., Williams, P. G., & Souza, R. (2019). Haemodynamic definitions and updated clinical classification of pulmonary hypertension. European Respiratory Journal, 53(1), 1801913.
https://doi.org/10.1183/13993003.01913-2018
6. Kovacs, G., Avian, A., Bachmaier, G., Troester, N., Tornyos, A., Douschan, P., Foris, V., Sassmann, T., Zeder, K., Lindenmann, J., Brcic, L., Fuchsjaeger, M., Agusti, A., & Olschewski, H. (2022). Severe pulmonary hypertension in COPD. CHEST, 162(1), 202-212.
https://doi.org/10.1016/j.chest.2022.01.031
7. Lin, C., Ge, Q., Wang, L., Zeng, P., Huang, M., & Li, D. (2024). Predictors, prevalence and prognostic role of pulmonary hypertension in patients with chronic kidney disease: A systematic review and meta-analysis. Renal Failure, 46(2).
https://doi.org/10.1080/0886022x.2024.2368082
8. Suleman, A., Abdullah, A., Ullah, R., Nisar, H., Iqbal, Z., Naz, S., & Maqsood, S. (2017). Frequency of pulmonary hypertension in chronic obstructive pulmonary disease patients. Pakistan Journal of Chest Medicine, 23(4), 151-55.
9. Mateen U, Munir S, Khan B. Frequency of Pulmonary Hypertension in Patients Presenting with COPD. World J Pharma Med Res. 2019;5(3):159-62.
http://pjcm.net/index.php/pjcm/article/view/484
10. Kumar, V., & Ghare, A. P. (2019). Prevalence of pulmonary hypertension in COPD patients. Journal of Evidence Based Medicine and Healthcare, 6(42), 2742-2745.
https://doi.org/10.18410/jebmh/2019/569
11. Mushtaq, F., Zeeshan, H. M., & Khan, S. (2017). Pulmonary Hypertension in Cases with Chronic Obstructive Pulmonary Disease. PAKISTAN JOURNAL OF MEDICAL & HEALTH SCIENCES, 11(2), 556-558.
12. Chaouat, A., Naeije, R., & Weitzenblum, E. (2008). Pulmonary hypertension in COPD. European Respiratory Journal, 32(5), 1371-1385.
https://doi.org/10.1183/09031936.00015608
13. Andersen, K. H., Iversen, M., Kjaergaard, J., Mortensen, J., Nielsen-Kudsk, J. E., Bendstrup, E., Videbaek, R., & Carlsen, J. (2012). Prevalence, predictors, and survival in pulmonary hypertension related to end-stage chronic obstructive pulmonary disease. The Journal of Heart and Lung Transplantation, 31(4), 373-380.
https://doi.org/10.1016/j.healun.2011.11.020
14. Shujaat, A., Minkin, R., & Eden, E. (2007). Pulmonary hypertension and chronic cor pulmonale in COPD. International journal of chronic obstructive pulmonary disease, 2(3), 273-282.
https://doi.org/10.2147/copd.s12159961
15. Seeger, W., Adir, Y., Barberà, J. A., Champion, H., Coghlan, J. G., Cottin, V., De Marco, T., Galiè, N., Ghio, S., Gibbs, S., Martinez, F. J., Semigran, M. J., Simonneau, G., Wells, A. U., & Vachiéry, J. (2013). Pulmonary hypertension in chronic lung diseases. Journal of the American College of Cardiology, 62(25), D109-D116.
https://doi.org/10.1016/j.jacc.2013.10.036
16. Thabut, G., Dauriat, G., Stern, J. B., Logeart, D., Levy, A., Marrash-Chahla, R., & Mal, H. (2005). Pulmonary hemodynamics in advanced COPD candidates for lung volume reduction surgery or lung transplantation. Chest, 127(5), 1531-1536.
https://doi.org/10.1378/chest.127.5.1531
17. Weitzenblum, E., Chaouat, A., & Kessler, R. (2013). Pulmonary hypertension in chronic obstructive pulmonary disease. Advances in Respiratory Medicine, 81(4), 390-398.
https://doi.org/10.5603/arm.34794
18. Maor, E., Grossman, Y, Balmor, R. G. (2021). Weight gain is associated with increased risk of pulmonary hypertension in patients with chronic obstructive pulmonary disease. Respiration, 91(5), 359-66.
19. Makarevich, A., E, Valevich, V. E., & Pochtavtsev, A. U. (2007). Evaluation of pulmonary hypertension in COPD patients with diabetes. 7 Reflections on the future of gastroenterology–unmet needs, 52, 265
20. Suleman, A., Abdullah, A., Ullah, R., Nisar, H., Iqbal, Z., Naz, S., & Maqsood, S. (2018). Frequency of Pulmonary Hypertension in Chronic Obstructive Pulmonary Disease Patients. Pakistan Journal of Chest Medicine, 23(4), 151–55.
https://www.pjcm.net/index.php/pjcm/article/view/484
21. Seimetz, M., Parajuli, N., Pichl, A., Veit, F., Kwapiszewska, G., Weisel, F., Milger, K., Egemnazarov, B., Turowska, A., Fuchs, B., Nikam, S., Roth, M., Sydykov, A., Medebach, T., Klepetko, W., Jaksch, P., Dumitrascu, R., Garn, H., Voswinckel, R., … Weissmann, N. (2011). Inducible NOS inhibition reverses tobacco-smoke-Induced emphysema and pulmonary hypertension in mice. Cell, 147(2), 293-305.
https://doi.org/10.1016/j.cell.2011.08.035
22. Wright, J. L. (2005). Pulmonary hypertension in chronic obstructive pulmonary disease: Current theories of pathogenesis and their implications for treatment. Thorax, 60(7), 605-609.
https://doi.org/10.1136/thx.2005.042994
23. KESSLER, R., FALLER, M., WEITZENBLUM, E., CHAOUAT, A., AYKUT, A., DUCOLONÉ, A., EHRHART, M., & OSWALD-MAMMOSSER, M. (2001). “Natural history” of pulmonary hypertension in a series of 131 patients with chronic obstructive lung disease. American Journal of Respiratory and Critical Care Medicine, 164(2), 219-224.
https://doi.org/10.1164/ajrccm.164.2.2006129
24. Aziz S, Baloch M, Mengal N. Pulmonary Arterial Hypertension in COPD and its Correlation with Disease Severity. P J M H S. 2023;17(2):602-604.
25. Agrawal, R., Gupta, N., Srivastav, A., & Ved, M. (2011). Echocardiographic evaluation of heart in chronic obstructive pulmonary disease patient and its Co-relation with the severity of disease. Lung India, 28(2), 105.
https://doi.org/10.4103/0970-2113.80321
26. Noordegraaf, A. V., Westerhof, B. E., & Westerhof, N. (2017). The relationship between the right ventricle and its load in pulmonary hypertension. Journal of the American College of Cardiology, 69(2), 236-243.
https://doi.org/10.1016/j.jacc.2016.10.047
27. Peinado, V. I., Pizarro, S., & Barbera, J. A. (2008). Pulmonary vascular involvement in COPD. Chest, 134(4), 808-814.
https://doi.org/10.7326/0003-4819-93-3-391
28. NOCTURNAL OXYGEN THERAPY TRIAL GROUP*. (1980). Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease: a clinical trial. Annals of internal medicine, 93(3), 391-398.
29. Prins, K. W., Thenappan, T., Weir, E. K., Kalra, R., Pritzker, M., & Archer, S. L. (2019). Repurposing medications for treatment of pulmonary arterial hypertension: What's old is new again. Journal of the American Heart Association, 8(1).
https://doi.org/10.1161/jaha.118.011343
30. Kovacs, G., Agusti, A., Barberà, J. A., Celli, B., Criner, G., Humbert, M., Sin, D. D., Voelkel, N., & Olschewski, H. (2018). Pulmonary vascular involvement in chronic obstructive pulmonary disease. Is there a pulmonary vascular phenotype? American Journal of Respiratory and Critical Care Medicine, 198(8), 1000-1011.
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