The effect of pulmonary hypertension on aerobic exercise capacity in lung transplant candidates with advanced COPD

Background: Mild pulmonary hypertension (PH) in patients with advanced COPD is common but its effects on exercise capacity are controversial. Objective : To investigated the effects of mild PH ( 35> mPAP ≥25 mmHG) on exercise capacity in lung transplant candidates with advanced COPD. Methods : We retrospectively reviewed and compare the hemodynamic data and cardiopulmonary exercise test (CPET) variable in advanced COPD patients, candidate for lung transplantation with and without PH determined on right heart catheterization. Results: 20 patients with COPD and no PH and 24 patients with COPD associated with mild PH included in the study. Both patients groups had severe airways obstruction with markedly reduced FEV1 (24.9%P±8.9 and 25.9%P±11.7, respectively), and severely reduced DLCO (35.2%P±17.3 and 39.2%P±15.9). No significant difference was found in any of the CPET variables except for VE/VCO 2 which was higher in patients with COPD and no PH and heart rate which was higher in the COPD and mild PH group. There was no correlation between mPAP and any of the exercise measurement. Conclusions: Our study suggests that exercise capacity in patients with advanced COPD is limited by the ventilatory impairment and the presence of mild PH has no farther impact on exercise capability.