Elevated pulmonary vascular resistance predicts mortality in COPD patients.

Chronic obstructive pulmonary disease (COPD) is frequently associated with mild to moderate pulmonary hypertension (PH). However, a small subset of patients develops severe PH, which is currently hemodynamically defined as mean pulmonary arterial pressure (mPAP)≥35 mmHg, or mPAP ≥25 mmHg in combination with cardiac index (CI)<2.0 L·min·m−2 [1, 2]. These cut-offs are, however, arbitrary and mainly based on expert opinion. In this study we aimed to determine prognostically relevant hemodynamic thresholds for severe PH in COPD by using an unbiased approach. Footnotes This manuscript has recently been accepted for publication in the European Respiratory Journal . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article. Conflict of interest: Dr. Zeder has nothing to disclose. Conflict of interest: Dr. Avian has nothing to disclose. Conflict of interest: Dr. Bachmaier has nothing to disclose. Conflict of interest: Dr. Douschan reports personal fees and non-financial support from Actelion, personal fees and non-financial support from GSK, non-financial support from Astra Zeneca, non-financial support from Bayer, non-financial support from MSD, non-financial support from Novartis, non-financial support from Teva, non-financial support from Boehringer Ingelheim, outside the submitted work. Conflict of interest: Dr. Foris reports non-financial support from Actelion, non-financial support from Chiesi, non-financial support from BMS, personal fees and non-financial support from Boehringer Ingelheim, personal fees and non-financial support from GSK, non-financial support from Menarini, personal fees and non-financial support from MSD, outside the submitted work. Conflict of interest: Dr. Sassmann has nothing to disclose. Conflict of interest: Dr. Troester has nothing to disclose. Conflict of interest: Dr. Brcic has nothing to disclose. Conflict of interest: Dr. Fuchsjager has nothing to disclose. Conflict of interest: Dr. Marsh has nothing to disclose. Conflict of interest: Dr. Maron has nothing to disclose. Conflict of interest: Dr. Olschewski reports grants from Bayer, Unither Pharmaceuticals, Actelion Pharmaceuticals Ltd., Roche, Boehringer Ingelheim and Pfizer Inc., personal fees from Gilead Sciences Inc., Encysive Pharmaceuticals Ltd. and Nebu-Tec, personal fees and non-financial support from Bayer, Unither Pharmaceuticals, Actelion Pharmaceuticals Ltd., Pfizer Inc., Eli Lilly, Novartis, Astra Zeneca, Boehringer Ingelheim, Chiesi, Menarini, MSD and GSK, outside the submitted work. Conflict of interest: Dr. Kovacs reports personal fees and non-financial support from Actelion, Janssen, Bayer, GSK, MSD, Boehringer Ingelheim, Novartis, Chiesi, Vitalaire, Ferrer, AOP, outside the submitted work.