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Elevated pulmonary vascular resistance predicts mortality in COPD patients

Katarina Zeder, Alexander Avian, Gerhard Bachmaier, Philipp Douschan, Vasile Foris, Teresa Sassmann, Natascha Troester, Luka Brcic, Michael Fuchsjaeger, Leigh Matthew Marsh, Bradley A. Maron, Horst Olschewski, Gabor Kovacs
European Respiratory Journal 2021 58: 2100944; DOI: 10.1183/13993003.00944-2021
Katarina Zeder
1Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
2Division of Pulmonology, Dept of Internal Medicine, Medical University of Graz, Graz, Austria
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Alexander Avian
3Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
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Gerhard Bachmaier
3Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
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Philipp Douschan
1Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
2Division of Pulmonology, Dept of Internal Medicine, Medical University of Graz, Graz, Austria
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Vasile Foris
1Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
2Division of Pulmonology, Dept of Internal Medicine, Medical University of Graz, Graz, Austria
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Teresa Sassmann
1Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
2Division of Pulmonology, Dept of Internal Medicine, Medical University of Graz, Graz, Austria
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Natascha Troester
2Division of Pulmonology, Dept of Internal Medicine, Medical University of Graz, Graz, Austria
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Luka Brcic
4Dept of Pathology, Medical University of Graz, Graz, Austria
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  • ORCID record for Luka Brcic
Michael Fuchsjaeger
5Dept of Radiology, Medical University of Graz, Graz, Austria
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Leigh Matthew Marsh
1Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
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Bradley A. Maron
6Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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Horst Olschewski
1Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
2Division of Pulmonology, Dept of Internal Medicine, Medical University of Graz, Graz, Austria
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  • For correspondence: horst.olschewski@medunigraz.at
Gabor Kovacs
1Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
2Division of Pulmonology, Dept of Internal Medicine, Medical University of Graz, Graz, Austria
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Extract

COPD is frequently associated with mild to moderate pulmonary hypertension (PH). However, a small subset of patients develops severe PH, which is currently haemodynamically defined as mean pulmonary arterial pressure (mPAP) ≥35 mmHg, or mPAP ≥25 mmHg in combination with cardiac index <2.0 L·min−1·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 haemodynamic thresholds for severe PH in COPD by using an unbiased approach.

Abstract

PVR >5 WU proved to be the strongest independent haemodynamic predictor of mortality in COPD patients. This threshold may best identify COPD patients with severe pulmonary vascular disease. https://bit.ly/3v4QE96

Acknowledgements

We thank Daniela Kleinschek for excellent assistance. We thank PH Austria Research Association and Self-Help Organization for their support.

Footnotes

  • This article has an editorial commentary: https://doi.org/10.1183/13993003.02008-2021

  • Author contributions: K. Zeder: study design and development, data analysis and interpretation, writing the paper, final approval of the submitted version. A. Avian and G. Bachmaier: statistical analysis, final approval of the submitted version. P. Douschan, V. Foris, T. Sassmann, N. Troester, L. Brcic, M. Fuchsjäger, L.M. Marsh and B.A. Maron: data interpretation, final approval of the submitted version. H. Olschewski: study design and development, data analysis and interpretation, final approval of the submitted version. G. Kovacs: study design and development, data analysis and interpretation, writing the paper, final approval of the submitted version. All authors contributed to the writing and editing of the manuscript.

  • Conflict of interest: K. Zeder has nothing to disclose.

  • Conflict of interest: A. Avian has nothing to disclose.

  • Conflict of interest: G. Bachmaier has nothing to disclose.

  • Conflict of interest: P. Douschan reports personal fees and non-financial support from Actelion and GSK, non-financial support from AstraZeneca, Bayer, MSD, Novartis, Teva and Boehringer Ingelheim, outside the submitted work.

  • Conflict of interest: V. Foris reports personal fees and non-financial support from Boehringer Ingelheim, GSK and MSD, non-financial support from Actelion, Chiesi, BMS and Menarini, outside the submitted work.

  • Conflict of interest: T. Sassmann has nothing to disclose.

  • Conflict of interest: N. Troester has nothing to disclose.

  • Conflict of interest: L. Brcic has nothing to disclose.

  • Conflict of interest: M. Fuchsjäger has nothing to disclose.

  • Conflict of interest: L.M. Marsh has nothing to disclose.

  • Conflict of interest: B.A. Maron has nothing to disclose.

  • Conflict of interest: H. 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, AstraZeneca, Boehringer Ingelheim, Chiesi, Menarini, MSD and GSK, outside the submitted work.

  • Conflict of interest: G. Kovacs reports personal fees and non-financial support from Actelion, Janssen, Bayer, GSK, MSD, Boehringer Ingelheim, Novartis, Chiesi, Vitalaire, Ferrer and AOP, outside the submitted work.

  • Received February 25, 2021.
  • Accepted April 14, 2021.
  • Copyright ©The authors 2021. For reproduction rights and permissions contact permissions{at}ersnet.org
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Elevated pulmonary vascular resistance predicts mortality in COPD patients
Katarina Zeder, Alexander Avian, Gerhard Bachmaier, Philipp Douschan, Vasile Foris, Teresa Sassmann, Natascha Troester, Luka Brcic, Michael Fuchsjaeger, Leigh Matthew Marsh, Bradley A. Maron, Horst Olschewski, Gabor Kovacs
European Respiratory Journal Aug 2021, 58 (2) 2100944; DOI: 10.1183/13993003.00944-2021

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Elevated pulmonary vascular resistance predicts mortality in COPD patients
Katarina Zeder, Alexander Avian, Gerhard Bachmaier, Philipp Douschan, Vasile Foris, Teresa Sassmann, Natascha Troester, Luka Brcic, Michael Fuchsjaeger, Leigh Matthew Marsh, Bradley A. Maron, Horst Olschewski, Gabor Kovacs
European Respiratory Journal Aug 2021, 58 (2) 2100944; DOI: 10.1183/13993003.00944-2021
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