RT Journal Article
SR Electronic
T1 Pulmonary Hypertension in COPD
JF Respiratory Care
FD American Association for Respiratory Care
SP respcare.02058
DO 10.4187/respcare.02058
A1 Matthias Held
A1 Berthold Jany
YR 2012
UL http://rc.rcjournal.com/content/early/2012/12/11/respcare.02058.abstract
AB Pulmonary hypertension (PH) is a common consequence of chronic obstructive pulmonary disease (COPD). It has been speculated that patients showing serious PH and vascular remodelling without severe airway obstruction might benefit from vasoactive treatment. There is no approved drug available for COPD-induced PH. Most trials assessing the efficacy of vasoactive drugs in PH have a follow-up of 12–16 weeks. We report on four patients with COPD and PH. Pulmonary arterial hypertension (PAH) associated diseases and pulmonary embolism were ruled out. PH persisted despite optimized treatment of underlying COPD and comorbidities. Therefore, Bosentan treatment was started in all the 4 patients. With Bosentan treatment, the mean pulmonary artery pressure (PAP) was found to improve. The average gain in six-minute walking distance (6MWD) at 2–3 months and 8–9 months was 36 m and 145 m, respectively. The maximum gain in 6MWD of the individual patients was noticed after the 9th, 13th, and 18th month. Oxygenation was found to be stable, and no side effects were observed. We suggest from this experience that in clinical trials of PH in COPD, a follow-up of 16 weeks might lead to an underestimation of the treatment effects.