Impact of pulmonary hypertension on exercise tolerance in patients with severe chronic obstructive pulmonary disease

Abstract

Summary. The purpose of this study was to investigate effects of pulmonary hypertension on exercise capacity in patients with severe chronic obstructive pulmonary disease (COPD). Lung function, mean pulmonary artery pressure (mPAP) and physical capacity were monitored in 30 patients with advanced COPD and pulmonary hypertension. mPAP was calculated from the acceleration time of pulmonary flow in Doppler echocardiographic examination. Exercise capacity was assessed by a distance walked in 6 min (6MWD) and by an incremental cardiopulmonary exercise test (CPET). We used Ergopneumotest equipment (Erich Jaeger, Germany) for CPET. There was no statistically significant difference in any of CPET and 6MWD variables between the patients with mPAP 25 mm Hg. There was no correlation between PAP and any of the exercise measurements. These results suggest that the exercise capacity in patients with advanced COPD and mild to moderate pulmonary hypertension is essentially limited by exhaustion of the ventilatory reserve.