Exercise capacity in COPD patients with exercise-induced pulmonary hypertension

Ingunn Skjørten,1,2 Janne Mykland Hilde,3 Morten Nissen Melsom,1 Jonny Hisdal,4 Viggo Hansteen,5 Kjetil Steine,2,3 Sjur Humerfelt6 1Department of Pulmonary Medicine, LHL Hospital Gardermoen, Jessheim, 2Faculty of Medicine, University of Oslo, Oslo, 3Department of Cardiology, Akershus University Hospital, Lørenskog, 4Section of Vascular Investigations, Oslo University Hospital-Aker, 5Department of Cardiology, Oslo University Hospital-Aker, 6Clinic of Allergology and Respiratory Medicine, Oslo, Norway Background: Pulmonary hypertension (PH) in patients with COPD is associated with reduced exercise capacity. A subgroup of COPD patients has normal mean pulmonary artery pressure (mPAP) at rest, but develops high mPAP relative to cardiac output (CO) during exercise, a condition we refer to as exercise-induced pulmonary hypertension (EIPH). We hypothesized that COPD patients with EIPH could be identified by cardiopulmonary exercise test (CPET) and that these patients have lower exercise capacity and more abnormal CPET parameters compared to COPD patients with normal hemodynamic exercise response.Methods: Ninety-three stable outpatients with COPD underwent right heart catheterization with the measurement of mPAP, CO, and capillary wedge pressure at rest and during supine exercise. Resting mPAP