Effect of pulmonary hypertension on exercise tolerance in patients with COPD: a prognostic systematic review and meta-analysis.
Eur Respir Rev
; 30(160)2021 Jun 30.
Article
en En
| MEDLINE
| ID: mdl-33927006
ABSTRACT
BACKGROUND:
Pulmonary hypertension (PH) is a frequent complication in patients with COPD.OBJECTIVE:
To determine if, in patients with COPD, the presence of PH decreases exercise tolerance.METHODS:
We included studies that analysed exercise tolerance using a cardiopulmonary exercise test (CPET) in patients with COPD with PH (COPD-PH) and without PH (COPD-nonPH). Two independent reviewers analysed the studies, extracted the data and assessed the quality of the evidence.RESULTS:
Of the 4915 articles initially identified, seven reported 257 patients with COPD-PH and 404 patients with COPD-nonPH. The COPD-PH group showed differences in peak oxygen consumption (V'O2peak ), -3.09â mL·kg-1·min-1 (95% CI -4.74 to -1.43, p=0.0003); maximum workload (Wmax), -20.5 W (95% CI -34.4 to -6.5, p=0.004); and oxygen pulse (O2 pulse), -1.24â mL·beat-1 (95% CI -2.40 to -0.09, p=0.03), in comparison to the group with COPD-nonPH. If we excluded studies with lung transplant candidates, the sensitivity analyses showed even bigger differences V'O2 , -4.26â mL·min-1·kg-1 (95% CI -5.50 to -3.02â mL·kg-1·min-1, p<0.00001); Wmax, -26.6 W (95% CI -32.1 to -21.1 W, p<0.00001); and O2 pulse, -2.04â mL·beat-1 (95% CI -2.92 to -1.15â mL·beat-1, p<0.0001).CONCLUSION:
Exercise tolerance was significantly lower in patients with COPD-PH than in patients with COPD-nonPH, particularly in nontransplant candidates.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Enfermedad Pulmonar Obstructiva Crónica
/
Hipertensión Pulmonar
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Eur Respir Rev
Año:
2021
Tipo del documento:
Article
País de afiliación:
España