Evolution and prognosis of pulmonary hypertension in chronic obstructive pulmonary diseases.

The prognostic value of the presence and degree of pulmonary arterial hypertension (PAH) in chronic obstructive pulmonary diseases (COPD) has been well established by recent studies including the European WHO multicentric study where 591 COPD patients have been included. The level of pulmonary artery mean pressure (PAP) is one of the best predictors of mortality in these patients along with FEV1 and arterial blood gases. The natural history of the course of PAP in COPD was relatively obscure until recent years.

[Hemodynamic and gasometric stability during right heart catheterization in chronic bronchopneumopathies].

In order to determine if blood gases and haemodynamic variables were steady after right heart catheterization, measurements were performed as soon as the catheter was placed, and after an interval ranging between 15 and 25 min in 22 patients with chronic lung disease. This study shows that there was no significant difference in blood gases, systemic and pulmonary vascular pressures, or cardiac output, except for pulmonary wedge pressure which decreased by 1.1 mmHg on average, and PaO2 which increased by 2.

Long-term oxygen therapy can reverse the progression of pulmonary hypertension in patients with chronic obstructive pulmonary disease.

Sixteen patients with severe chronic obstructive pulmonary disease (COPD) (average values at the onset of O2 therapy: FEV1, 891 +/- 284 ml; PaO2, 50.2 +/- 6.6 mmHg; PaCO2, 51.

[Noninvasive diagnosis of pulmonary arterial hypertension in chronic respiratory insufficiency].

A precise assessment of pulmonary arterial hypertension (HTAP) in chronic lung disorders is not possible without right heart catheterisation. In spite of technological advances (floating catheters with or without balloons) the examination remains invasive, at least to a certain degree, in addition it is not currently practiced in respiratory function laboratories or in services specialising in thoracic medicine. The diagnosis of HTAP is important when considering both the prognosis and the therapeutic approach notably in chronic airflow obstruction (BPCO) and thus the interest in non-invasive diagnostic methods for HTAP.

Long-term course of pulmonary arterial pressure in chronic obstructive pulmonary disease.

Ninety-three patients with severe chronic obstructive pulmonary disease (COPD) of the bronchitic (n = 74) or emphysematous type (n = 19), who all had arterial hypoxemia, underwent 2 right cardiac catheterizations in a clinical steady state, with a delay of 5 yr or more between the first and the last catheterization. No patients received long-term O2 therapy or pulmonary vasodilator drugs. Patients were divided into 2 groups according to the initial level of mean pulmonary artery pressure (Pap).

Evolution of pulmonary hypertension in chronic obstructive pulmonary diseases.

The prognostic value of the presence and degree of pulmonary arterial hypertension in chronic obstructive pulmonary diseases has been well established, but the natural history of the course of pulmonary artery mean pressure was relatively obscure until recent years. The first studies showed a modest increase in pulmonary artery mean pressure after an average delay of 3-5 years. More recently, studying a group of 35 patients with chronic bronchitis, most of them exhibiting pulmonary arterial hypertension followed-up for a mean period of 3 years, Schrijen et al.