Document Detail

Abnormal pulmonary arterial pressure limits exercise capacity in patients with COPD.
MedLine Citation:
PMID:  19122986     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Pulmonary hypertension (PH) is common in patients with chronic obstructive pulmonary disease (COPD). Mean pulmonary artery pressure (mPAP) is often only slightly elevated at rest but is increased by exercise. The purpose of this study was to determine whether abnormal pulmonary artery pressure impairs exercise capacity in patients with COPD. PATIENTS AND METHODS: 42 patients with moderate-to-very-severe COPD (28 men, 14 women) underwent symptom-limited incremental cardiopulmonary exercise testing and also right-heart catheterization at rest. Abnormal pulmonary artery pressure was defined as mPAP>20 mmHg at rest. RESULTS: Resting mPAP was elevated in 32 patients (PH, mPAP=26.8+/-5.9 mmHg) and normal in 10 non-hypertensive (NPH) patients (NPH, mPAP=16.8+/-2 mmHg). There were no significant differences in lung function between the PH and NPH groups. Maximum oxygen uptake during exercise (VO2max) was significantly lower in PH (785+/-244 ml/min) than in NPH (1052+/-207 ml/min, P=0.004). Dead-space ventilation (Vd/Vt) was greater in PH (P=0.05) with higher VE/VCO2 (ratio of minute ventilation to carbon dioxide output=47.3+/-10 vs 38.6+/-3.5, P=0.025) and significantly higher arterial-end-tidal pCO2 difference [p(a-ET)CO2]. Pulmonary vascular resistance measured at rest correlated significantly with VO2max, VE/VCO2 and p(a-ET)CO2. CONCLUSIONS: In patients with COPD, abnormal pulmonary artery pressure impairs gas exchange, decreases maximum oxygen uptake during exercise and impairs exercise capacity.
Karin Vonbank; Georg Christian Funk; Beatrice Marzluf; Bernhard Burian; Rolf Ziesche; Leopold Stiebellehner; Ventzislav Petkov; Paul Haber
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Wiener klinische Wochenschrift     Volume:  120     ISSN:  0043-5325     ISO Abbreviation:  Wien. Klin. Wochenschr.     Publication Date:  2008  
Date Detail:
Created Date:  2009-01-05     Completed Date:  2009-02-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  21620870R     Medline TA:  Wien Klin Wochenschr     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  749-55     Citation Subset:  IM    
Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
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MeSH Terms
Carbon Dioxide / blood
Exercise Test*
Hypertension, Pulmonary / physiopathology*
Lung Volume Measurements
Middle Aged
Oxygen / blood
Pulmonary Disease, Chronic Obstructive / physiopathology*
Pulmonary Gas Exchange
Pulmonary Wedge Pressure / physiology
Reference Values
Respiratory Dead Space / physiology
Vascular Resistance / physiology
Ventilation-Perfusion Ratio / physiology
Reg. No./Substance:
124-38-9/Carbon Dioxide; 7782-44-7/Oxygen

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