%0 Journal Article %T Severe Pulmonary Hypertension Associated with COPD: Hemodynamic Improvement with Specific Therapy %+ Service de pneumologie [Rennes] = Pneumology [Rennes] %+ Institut de recherche en santé, environnement et travail (Irset) %+ Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes] %+ Université Claude Bernard Lyon 1 (UCBL) %+ Hôpital Louis Pradel [CHU - HCL] %+ Service de Pneumologie %A Girard, Anne %A Jouneau, Stéphane %A Chabanne, Céline %A Khouatra, Chahéra %A Lannes, Morgane %A Traclet, Julie %A Turquier, Ségolène %A Delaval, P. %A Cordier, J.-F. %A Cottin, Vincent %< avec comité de lecture %@ 0025-7931 %J Respiration %I Karger %V 90 %N 3 %P 220--228 %8 2015 %D 2015 %R 10.1159/000431380 %M 26277885 %K pulmonary hypertension %K chronic obstructive pulmonary disease %K right heart catheterization %K echocardiography %K endothelin receptor antagonists %K phosphodiesterase-5 inhibitors %Z Life Sciences [q-bio]Journal articles %X Background - There is no recommendation for treating pulmonary hypertension (PH) when associated with chronic obstructive pulmonary disease (COPD). Objective - To evaluate the effect of PH-specific therapy in patients with COPD. Methods - All successive patients with severe PH [mean pulmonary arterial pressure (mPAP) ≥35 mm Hg] and COPD, who received specific PH medication and who underwent right heart catheterization at baseline and after 3-12 months of treatment, were analyzed from a prospective database. Results - Twenty-six patients were included with a median follow-up of 14 months. Mean forced expiratory volume in 1 s was 57 ± 20% of predicted, and mean forced expiratory volume in 1 s/forced vital capacity was 47 ± 12%. Dyspnea was New York Health Association classification stage (NYHA) II in 15%, NYHA III in 81% and NYHA IV in 4%. First-line treatments were endothelin receptor antagonists in 11 patients, phosphodiesterase-5 inhibitors in 11 patients, calcium blocker in 1 patient, combination therapy in 3 patients including 2 with a prostanoid. After 6 ± 3 months, pulmonary vascular resistance decreased from 8.5 ± 3 to 6.6 ± 2 Wood units (p < 0.001), with significant improvement of cardiac index from 2.44 ± 0.43 to 2.68 ± 0.63 liters × min × m-2 (p = 0.015) and mPAP from 48 ± 9 to 42 ± 10 mm Hg (p = 0.008). There was no significant difference in dyspnea, 6-min walking distance, echocardiographic parameters or N-terminal pro-brain natriuretic peptide levels. There was no significant difference in arterial oxygen saturation after 3-12 months of treatment. Conclusions - Specific PH medications may improve hemodynamic parameters in COPD patients with severe PH. Appropriate prospective randomized studies are needed to evaluate the potential long-term clinical benefit of treatment. %G English %L hal-01239807 %U https://univ-rennes.hal.science/hal-01239807 %~ HCL %~ UNIV-RENNES1 %~ UNIV-LYON1 %~ UNIV-ANGERS %~ IFR140 %~ HL %~ IRSET %~ STATS-UR1 %~ IRSET-SMS %~ IRSET-CCII %~ IRSET-TREC %~ IRSET-HIAEC %~ IRSET-SMLF %~ IRSET-ERD %~ IRSET-VCER %~ IRSET-NEED %~ IRSET-TNGC %~ UR1-UFR-SVE %~ UR1-HAL %~ UR1-SDV %~ IRSET-1 %~ TEST-UNIV-RENNES %~ TEST-UR-CSS %~ UNIV-RENNES %~ UDL %~ UNIV-LYON %~ IRSET-1-EX-IRSET-CCII %~ UR1-BIO-SA