Background: Pulmonary hypertension (PH) is a frequent complication in patients with COPD.
Objective: To determine if, in patients with COPD, the presence of PH decreases exercise tolerance.
Methods: We included studies that analysed exercise tolerance using a cardiopulmonary exercise test (CPET) in patients with COPD with PH (COPD-PH) and without PH (COPD-nonPH). Two independent reviewers analysed the studies, extracted the data and assessed the quality of the evidence.
Results: Of the 4915 articles initially identified, seven reported 257 patients with COPD-PH and 404 patients with COPD-nonPH. The COPD-PH group showed differences in peak oxygen consumption (' ), -3.09 mL·kg·min (95% CI -4.74 to -1.43, p=0.0003); maximum workload (W), -20.5 W (95% CI -34.4 to -6.5, p=0.004); and oxygen pulse (O pulse), -1.24 mL·beat (95% CI -2.40 to -0.09, p=0.03), in comparison to the group with COPD-nonPH. If we excluded studies with lung transplant candidates, the sensitivity analyses showed even bigger differences: ' , -4.26 mL·min·kg (95% CI -5.50 to -3.02 mL·kg·min, p<0.00001); W, -26.6 W (95% CI -32.1 to -21.1 W, p<0.00001); and O pulse, -2.04 mL·beat (95% CI -2.92 to -1.15 mL·beat, p<0.0001).
Conclusion: Exercise tolerance was significantly lower in patients with COPD-PH than in patients with COPD-nonPH, particularly in nontransplant candidates.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9489125 | PMC |
| http://dx.doi.org/10.1183/16000617.0321-2020 | DOI Listing |
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