Egyptian Journal of Chest Disease and Tuberculosis (Jan 2018)

Clinical and investigational profiles of elevated pulmonary artery pressures in patients with stable chronic obstructive pulmonary diseases

  • Mohammed A Agha,
  • Maha Yousif,
  • Rehab M Habib,
  • Waleed Abdou,
  • Nesreen G El-Helbawy

DOI
https://doi.org/10.4103/ejcdt.ejcdt_49_18
Journal volume & issue
Vol. 67, no. 4
pp. 394 – 400

Abstract

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Background Pulmonary hypertension (PH) is a major predictor of exercise tolerance and mortality in chronic obstructive pulmonary disease (COPD). The confirmatory and gold standard is the right heart catheterization. Noninvasive, simple and readily available parameters to frequently monitor patients with COPD are much needed. Objective To evaluate various clinical and investigational parameters such as BMI, airway obstruction, dyspnea, and exercise [BODE index capacity by 6-minutes walking test (6MWT)], computed tomography (CT) pulmonary artery/ascending aorta ratio (PA/AO), and serum ghrelin in patients with COPD with elevated PA pressures in different disease stages. Patient and methods A total of 40 patients with stable COPD were classified into two groups, group I patients without PH and group II patients with PH, according to echocardiographic measures. All patients are subjected to calculation of BODE index, serum ghrelin levels, and CT PA/AO. Results There was a significant difference between both groups regarding BODE index, PA/AO, serum ghrelin level, and post-MWT O2 saturation. There were positive significant correlations between the mean PA pressure and BODE index, PA/AO ratio, and serum ghrelin level. However, there were negative significant correlations regarding resting PaO2, post-6MWT O2, and pulmonary function tests. The cutoff value of PA/AO ratio was 0.84 in diagnosing PH with 95% sensitivity and 80% specificity, and the cutoff value of serum ghrelin level was 1694 ng/l in diagnosing PH with 98% sensitivity and 88% specificity. Conclusion BODE index, CT PA/AO ratio, post-6MWT oxygen saturation, and serum ghrelin level are useful noninvasive predictors for PH. A cutoff point of PA/AO of 0.84 and ghrelin of more than 1712 ng/l can be used for detection of elevated PA pressures in those patients.

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