Pulmonary hypertension associated with chronic obstructive pulmonary disease

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Pulmonary hypertension associated with chronic obstructive pulmonary disease (PH-COPD) can be a common complication of chronic obstructive pulmonary disease and usually manifests as mild to moderate pulmonary hypertension in those with advanced COPD. Pulmonary arterial pressures in this situation most ranges around 25-35 mmHg 3. A small proportion of COPD patients may present of a severe or "disproportionate" pulmonary arterial pressures with resting pulmonary arterial pressures around > 35-40 mmHg 3

Epidemiology

The reported incidence of mild to moderate pulmonary hypertension is as high as 50% of cases with advanced chronic obstructive pulmonary disease 5.

Pathology

Pulmonary vascular remodelling in COPD is considered the main cause of increased pulmonary arterial pressures and is thought to be a result of combined effects of hypoxia, inflammation and loss of capillaries in severe emphysema.

Radiographic features

CT 

Imaging may show concurrent presence of features of pulmonary hypertension as well as features of COPD / emphysema although a causative / associative relationship requires careful consideration of clinical features and absence of features than overtly contribute or pulmonary hypertension.

  • -<p><strong>Pulmonary hypertension associated with chronic obstructive pulmonary disease (PH-COPD)</strong> can be a common complication of <a title="Chronic obstructive pulmonary disease" href="/articles/chronic-obstructive-pulmonary-disease-1">chronic obstructive pulmonary disease</a> and usually manifests as mild to moderate <a title="pulmonary hypertension" href="/articles/pulmonary-hypertension">pulmonary hypertension</a> in those with advanced COPD. Pulmonary arterial pressures in this situation most ranges around 25-35 mmHg <sup>3</sup>. A small proportion of COPD patients may present of a severe or "disproportionate" pulmonary arterial pressures with resting pulmonary arterial pressures around &gt; 35-40 mmHg <sup>3</sup>. </p><h4>Pathology</h4><p>Pulmonary vascular remodelling in COPD is considered the main cause of increased pulmonary arterial pressures and is thought to be a result of combined effects of hypoxia, inflammation and loss of capillaries in severe emphysema.</p><h4>Radiographic features</h4><h5>CT </h5><p>Imaging may show concurrent presence of features of pulmonary hypertension as well as features of COPD / emphysema although a causative / associative relationship requires careful consideration of clinical features and absence of features than overtly contribute or pulmonary hypertension.</p><p> </p><p> </p>
  • +<p><strong>Pulmonary hypertension associated with chronic obstructive pulmonary disease (PH-COPD)</strong> can be a common complication of <a href="/articles/chronic-obstructive-pulmonary-disease-1">chronic obstructive pulmonary disease</a> and usually manifests as mild to moderate <a href="/articles/pulmonary-hypertension">pulmonary hypertension</a> in those with advanced COPD. Pulmonary arterial pressures in this situation most ranges around 25-35 mmHg <sup>3</sup>. A small proportion of COPD patients may present of a severe or "disproportionate" pulmonary arterial pressures with resting pulmonary arterial pressures around &gt; 35-40 mmHg <sup>3</sup>. </p><h4>Epidemiology</h4><p>The reported incidence of mild to moderate pulmonary hypertension is as high as 50% of cases with advanced chronic obstructive pulmonary disease <sup>5</sup>.</p><h4>Pathology</h4><p>Pulmonary vascular remodelling in COPD is considered the main cause of increased pulmonary arterial pressures and is thought to be a result of combined effects of hypoxia, inflammation and loss of capillaries in severe emphysema.</p><h4>Radiographic features</h4><h5>CT </h5><p>Imaging may show concurrent presence of features of pulmonary hypertension as well as features of COPD / emphysema although a causative / associative relationship requires careful consideration of clinical features and absence of features than overtly contribute or pulmonary hypertension.</p>

References changed:

  • 1. Vizza C, Hoeper M, Huscher D et al. Pulmonary Hypertension in Patients With COPD. Chest. 2021;160(2):678-89. <a href="https://doi.org/10.1016/j.chest.2021.02.012">doi:10.1016/j.chest.2021.02.012</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/33581097">Pubmed</a>
  • 2. Chaouat A, Naeije R, Weitzenblum E. Pulmonary Hypertension in COPD. Eur Respir J. 2008;32(5):1371-85. <a href="https://doi.org/10.1183/09031936.00015608">doi:10.1183/09031936.00015608</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/18978137">Pubmed</a>
  • 3. Weitzenblum E, Chaouat A, Kessler R. Pulmonary Hypertension in Chronic Obstructive Pulmonary Disease. Pneumonol Alergol Pol. 2013;81(4):390-8. - <a href="https://www.ncbi.nlm.nih.gov/pubmed/23744170">Pubmed</a>
  • 4. Cassady S & Reed R. Pulmonary Hypertension in COPD: A Case Study and Review of the Literature. Medicina (Kaunas). 2019;55(8):432. <a href="https://doi.org/10.3390/medicina55080432">doi:10.3390/medicina55080432</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/31382489">Pubmed</a>
  • 5. Zakynthinos E, Daniil Z, Papanikolaou J, Makris D. Pulmonary Hypertension in COPD: Pathophysiology and Therapeutic Targets. Curr Drug Targets. 2011;12(4):501-13. <a href="https://doi.org/10.2174/138945011794751483">doi:10.2174/138945011794751483</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/21194405">Pubmed</a>

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