Risk Factors Associated with Development of Pulmonary Arterial Hypertension and Corpulmonale in Patients with Chronic Obstructive Pulmonary Disease

Abstract

Background: Chronic Obstructive Pulmonary Disease is an important cause of morbidity and mortality globally. The onset of pulmonary hypertension and corpulmonale is associated with decreased survival in patients with COPD. Objective: To assess risk factors associated with the development of pulmonary hypertension and corpulmonale and to identify high-risk phenotypes who may need early evaluation and intervention. Methods: Consecutive adult patients with COPD were evaluated for factors influencing the development of pulmonary hypertension and corpulmonale which included symptomatology, hospitalization in the previous year, MMRC dyspnea grade, SGRQ score, 6 minute walk test, ABG, CRP, spirometry and echocardiography. Results: We found Pulmonary Hypertension in 36(30%) patients and 27(22.5%) had corpulmonale. On multivariate analysis, we found PaO2 ≤75 mm Hg and six minute walk test <80% predicted to be significantly associated with the development of Pulmonary hypertension and we found hospitalization in the previous year to be significantly and independently associated with the development of corpulmonale. Conclusion: We observed hospitalization in the previous year was an independent risk factor for the development of corpulmonale and six-minute walk test <80% predicted, PaO2 <75 mm Hg were independent risk factors for the development of pulmonary hypertension.