Association Between the Severity of Chronic Obstructive Pulmonary Disease and the Probability of Pulmonary Hypertension In a Tertiary Hospital
DOI:
https://doi.org/10.36497/jri.v45i2.873Keywords:
Brinkman index, COPD, pulmonary hypertensionAbstract
Background: Chronic obstructive pulmonary disease (COPD) patients with pulmonary hypertension (PH) have a poor prognosis, which worries doctors. The prevalence of COPD-related PH is unclear. The lack of anatomical criteria for right ventricular hypertrophy may explain research variance. Only type 1 PH patients undergo direct right cardiac catheterization of pulmonary artery pressure.
Methods: A cross-sectional analytical descriptive study examined stable COPD patients visiting the pulmonary department at M. Djamil Hospital, Padang, from November 2023 to February 2024 for PH probability.
Results: This study included 64 participants, with a majority aged between 40 and 65 years (59.4%), a significant proportion male (82.8%), and a junior high school (29.7%) level of education. Most of the subjects smoked (81.2%), had severe Brinkman Index (75.0%), had severe GOLD criteria (50.0%), and had no comorbidities (53.1%). No correlation was found between the severity of COPD and the likelihood of PH (P=0.591). The Brinkman Index of smokers was a significant risk factor for PH (P=0.010; OR=1.282; 95% CI=0.260-6.315).
Conclusion: There is no significant association between the severity of COPD according to GOLD criteria and the likelihood of PH.
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References
1. Simonneau G, Montani D, Celermajer DS, Denton CP, Gatzoulis MA, Krowka M, et al. Haemodynamic definitions and updated clinical classification of pulmonary hypertension. European Respiratory Journal. 2019;53(1):1801913.
2. Agus AW, Adrianison A, Siswanty D, Yunus F, Zahtamal Z. Chronic obstructive pulmonary disease with incidence of heart failure and its influencing factors. Jurnal Respirasi. 2022;8(1):7–14.
3. Safitri Y, Siregar AA, Mukhtar Z. Hubungan derajat keparahan penyakit paru obstruktif kronik dengan temuan patologis ekokardiografi di Rumah Sakit Umum Pusat Haji Adam Malik Medan. Universitas Sumatera Utara Press. [Medan]: Universitas Sumatera Utara; 2019.
4. Shapiro BP, McGoon MD, Redfield MM. Unexplained pulmonary hypertension in elderly patients. Chest. 2007;131(1):94–100.
5. Zhang L, Liu Y, Zhao S, Wang Z, Zhang M, Zhang S, et al. The incidence and prevalence of pulmonary hypertension in the COPD population: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis. 2022;17:1365–79.
6. Oldroyd SH, Manek G, Bhardwaj A. Pulmonary hypertension. StatPearls [Internet], editor. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. 7–89 p.
7. Thenappan T, Shah SJ, Gomberg-Maitland M, Collander B, Vallakati A, Shroff P, et al. Clinical characteristics of pulmonary hypertension in patients with heart failure and preserved ejection fraction. Circ Heart Fail. 2011;4(3):257–65.
8. Sertogullarindan B, Gumrukcuoglu HA, Sezgi C, Akil MA. Frequency of pulmonary hypertension in patients with COPD due to biomass smoke and tobacco smoke. Int J Med Sci. 2012;9(6):406–12.
9. Basak S, Mukherjee R, Chowdhury S, Roy S, Banerjee R, Bhattacharya R. Evaluation of cardiac function in COPD patients and correlation with disease severity: a cross sectional study. Asian J Med Sci. 2021;12(3):14–9.
10. Naeije R, D’Alto M. Sex matters in pulmonary arterial hypertension. Eur Respir J. 2014;44(2):553–4.
11. Ventetuolo CE, Praestgaard A, Palevsky HI, Klinger JR, Halpern SD, Kawut SM. Sex and haemodynamics in pulmonary arterial hypertension. Eur Respir J. 2014;43(2):523–30.
12. Rodriguez-Arias JJ, García-Álvarez A. Sex differences in pulmonary hypertension. Front Aging. 2021;2:727558.
13. Luca E, Bodrug N. The frequency of pulmonary hypertension in chronic obstructive pulmonary disease of geriatric patients: a narrative literature review. Egypt J Intern Med. 2022;34:47.
14. Lutter JI, Jörres RA, Welte T, Watz H, Waschki B, Alter P, et al. Impact of education on COPD severity and all-cause mortality in lifetime never-smokers and longtime ex-smokers: results of the cosyconet cohort. Int J Chron Obstruct Pulmon Dis. 2020;15:2787–98.
15. Mohammed YM, ElShahid GS, Osman NM, Abd ElHameed NQ. Cardiac evaluation of patients with chronic obstructive pulmonary disease using echocardiography. Egyptian Journal of Bronchology. 2019;13:12–6.
16. Jain S, Jain A, MKhoja A. Effect of smoking on pulmonary hypertension: prospective observational study. Sch J App Med Sci. 2019;7(7):2335–8.
17. Imaizumi Y, Eguchi K, Kario K. Lung disease and hypertension. Pulse. 2014;2(1–4):103–12.
18. Kim SH, Park JH, Lee JK, Heo EY, Kim DK, Chung HS. Chronic obstructive pulmonary disease is independently associated with hypertension in men: a survey design analysis using nationwide survey data. Medicine (Baltimore). 2017;96(19):e6826.
19. Barnes PJ, Celli BR. Systemic manifestations and comorbidities of COPD. Eur Respir J. 2009;33(5):1165–85.
20. Badesch DB, Champion HC, Gomez Sanchez MA, Hoeper MM, Loyd JE, Manes A, et al. Diagnosis and assessment of pulmonary arterial hypertension. J Am Coll Cardiol. 2009;54(1 Suppl):S55–66.
21. Cassady SJ, Reed RM. Pulmonary hypertension in COPD: a case study and review of the literature. Medicina (B Aires). 2019;55(8):432.
22. Barberà JA, Peinado VI, Santos S. Pulmonary hypertension in chronic obstructive pulmonary disease. Eur Respir J. 2003;21(5):892–905.
23. Chaouat A, Naeije R, Weitzenblum E. Pulmonary hypertension in COPD. Eur Respir J. 2008 Nov;32(5):1371–85.
24. Aguirre-Franco C, Torres-Duque CA, Salazar G, Casas A, Jaramillo C, Gonzalez-Garcia M. Prevalence of pulmonary hypertension in COPD patients living at high altitude. Pulmonology. 2024;30(3):247–53.
25. Medrek SK, Sharafkhaneh A, Spiegelman AM, Kak A, Pandit LM. Admission for COPD exacerbation is associated with the clinical diagnosis of pulmonary hypertension: results from a retrospective longitudinal study of a veteran population. COPD. 2017;14(5):484–9.
26. Nathan SD, Barbera JA, Gaine SP, Harari S, Martinez FJ, Olschewski H, et al. Pulmonary hypertension in chronic lung disease and hypoxia. European Respiratory Journal. 2020;53(1):1801914.
27. Blanco I, Tura-Ceide O, Peinado VI, Barberà JA. Updated perspectives on pulmonary hypertension in COPD. Int J Chron Obstruct Pulmon Dis. 2020;15:1315–24.
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