Source: Annual Congress 2008 - Physiological response to exercise performance
Disease area: Airway diseases, Pulmonary vascular diseases

Abstract

Rationale: Elevation of pulmonary arterial pressure (PAP) may complicate advanced COPD. A subgroup of COPD patients with mild-moderate pulmonary hypertension at rest may develop sharp increase in PAP during exercise. This observation may have therapeutic consequence in pulmonary rehabilitation.
Methods: 17 patients with stable, severe COPD (FEV1: 40±13 %pred) performed two incremental cycle ergometer tests with identical ramp protocol, one with gas exchange detection and the other with PAP measurement with echocardiography during exercise. Serum CRP levels were also determined.
Results: At peak exerise, reduced values for WR (96±37 Watts) and VO2 (62±18 %pred) with no breathing reserve (VE: 101±31 %MVV) were detected. Systolic PAP was 40±5 mmHg at rest and 75±13 mmHg at peak exercise (p<0,001). In 10 patients, PAP increased >25 mmHg. Right vetricular systolic function was normal at rest and during exercise (TAPSE rest: 26±5 mm vs. peak: 37±6 mm, p<0,001). CRP levels were elevated (15±8 mg/L).
Conclusion: Elevation of PAP during exercise in advanced COPD may be sigificant, particularly in those with high CRP values. In order to avoid compromised pulmonary hemodynamics, interval exercise training during rehabilitation might be a better option for this group of patients.

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Citations should be made in the following way:
J. Varga, I. Lajko, R. Palfoldi, A. Palinkas, A. Somfay (Deszk, Hodmezovasarhely, Hungary). Elevated pulmonary pressure during exercise in COPD. Eur Respir J 2008; 32: Suppl. 52, 3292

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