In Rotterdam, size really does matter: implications of pulmonary artery enlargement on mortality

• Published in: The European respiratory journal Vol. 49; no. 6; p. 1700750
• Main Authors: Zouk, Aline N, Wells, J Michael
• Format: Journal Article
• Language: English
• Published: England European Respiratory Society Journals Ltd 01.06.2017
• Subjects: Chronic obstructive pulmonary disease; Dyspnea; Fatigue; Hypertension; Hypoxia; Lung diseases; Mortality; Obstructive lung disease; Pulmonary arteries; Pulmonary artery; Pulmonary hypertension; Quality of life; Respiration
• ISSN: 0903-1936; 1399-3003
• DOI: 10.1183/13993003.00750-2017

For quite some time, we have known that pulmonary hypertension (PH) is associated with an increased risk of death in chronic obstructive pulmonary disease (COPD) [1, 2]. The occurrence of PH in the context of chronic lung diseases is often the result of hypoxic pulmonary hypertension and is classified as Group III PH by the World Health Organization (WHO) [3]. The diagnosis of PH requires a high index of suspicion, as symptoms are often vague and nonspecific, particularly among individuals with pre-existing respiratory disease. PH is defined by hemodynamic measurement during right-sided heart catheterisation (RHC), even though RHC is not routinely performed in COPD, because of the invasive nature of the procedure and the lack of efficacious treatments [4–6]. Comorbid PH independently accounts for worsening dyspnoea, fatigue, impaired exercise tolerance and poor quality of life in COPD [7, 8], and is associated with increased risk of hospitalisation and higher mortality [2, 3, 9].