Description
Title: Chronic obstructive pulmonary disease and pulmonary hypertension
Abstract: A mean pulmonary artery pressure (PAP) of less than 25 mm Hg at rest in the supine position is referred to as having pulmonary hypertension (PH), which is a common complication of advanced chronic obstructive pulmonary disease (COPD). Due to its prevalence, COPD is a common cause of PH; in fact, it ranks second in terms of frequency, just behind left heart diseases. Chronic alveolar hypoxia is the primary morphological and functional cause of PH, which is brought on by an increase in pulmonary vascular resistance. When COPD is in a stable state, PAP typically ranges between 25 and 35 mm Hg, and PH is typically mild to moderate. With a resting PAP > 35–40 mm Hg, a small percentage of COPD patients may exhibit a severe or “disproportionate” PH. These patients have a particularly poor prognosis. Exercise, sleep, and severe disease flare-ups all worsen PH in COPD, and these abrupt increases in afterload may favor the onset of right heart failure. Doppler echocardiography is the primary method used to diagnose PH, and only a small percentage of patients require right heart catheterization. Long-term oxygen therapy ( 16 hours per day), which usually stabilizes or at least slows the progression of PH, is the mainstay of treatment for PH in COPD. We lack studies on the use of vasodilator medications, which are frequently used in idiopathic pulmonary arterial hypertension, in COPD. Patients with severe PH should be referred to a specialized PH center, where it should be discussed whether they might be eligible to participate in a carefully monitored clinical trial.
Keywords: COPD, pulmonary hypertension, chronic respiratory failure, pulmonary vascular resistance, out of proportion pulmonary hypertension
Paper Quality: SCOPUS / Web of Science Level Research Paper
Subject: Advances in Respiratory Medicine
Writer Experience: 20+ Years
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