Pulmonary Hypertension Secondary to COPD

Table 7

Baseline characteristics of the patients who received pulmonary vasodilators in the published studies of such drugs in COPD.

First author	Alp et al. [88]	Holverda et al. [89]	Rietema et al. [90]	Stolz et al. [95]	Valerio et al. [96]	Blanco et al. [91]	Rao et al. [94]
Year of publication	2006	2008	2008	2008	2009	2010	2011
Drug	Sildenafil	Sildenafil	Sildenafil	Bosentan	Bosentan	Sildenafil	Sildenafil
Dose	50 mg BID	50 mg	50 mg TID	125 mg BID	125 mg BID	20 mg vs 40 mg	20 mg TID
Duration	3 months	Acute effects	3 months	3 months	18 months	Acute effects	3 months
Total N	5	18	15	20	20	20	17
N with PH	5	11	9	14^†	20	12	17
N with resting PH*	5	5	5	14^†	20	12	17
Age (years)	45–64	66 ± 9	65 ± 2	69.5 ± 8.8	66 ± 9	64 ± 7	60 ± 7
sPAP (mm Hg)				32^‡			53 ± 12
mPAP (mm Hg)	29.5 ± 5.2	23 ± 10	22 ± 9		37 ± 5	27 ± 10	33.8 ± 9.2 ^§
CO (L/min)		5.5 ± 1.0	5.4 ± 1.7	2.45 ± 0.4	2.8 ± 0.7	4.9 ± 0.95
CI (L/min/m^2)						2.7 ± 0.44
PVR (dynes.s.cm^−5)	373 ± 118	280 ± 180	259 ± 166	158 ± 30	442 ± 192	339 ± 165
FEV1 (% predicted)	16–48	52 ± 26	49 ± 24	38 ± 13	37 ± 18	35 ± 11	32.5 ± 11
TLC (% predicted)		126 ± 15	125 ± 16	126 ± 15	132 ± 6	114 ± 19
DLCO (% predicted)		46 ± 17	48 ± 16	37 ± 18	34 ± 7	44 ± 17
SpO2 (%)		93 ± 4	95 ± 2	93 ± 3
PaO2 (mm Hg)			74 ± 13		57 ± 10	64 ± 11
PaCO2 (mm Hg)			39 ± 6		46 ± 8	38.4 ± 4.5
6MWD (meters)	351 ± 49		385 ± 135	339 ± 81	257 ± 150	396 ± 114	269 ± 140

mg: milligrams, BID: twice a day, TID: three times a day, vs: versus, N: total number of patients who received the study drug, N with PH: number of patients with pulmonary hypertension, PH: pulmonary hypertension, sPAP: systolic pulmonary artery pressure estimated by echocardiography, mPAP: mean pulmonary artery pressure measured by right heart catheterization, CO: cardiac output, CI: cardiac index, PVR: pulmonary vascular resistance, FEV1: forced expiratory volume in the first second, TLC: total lung capacity, DLCO: diffusing capacity for carbon monoxide, SpO₂: oxygen saturation by pulse oximetry, PaO₂: arterial oxygen tension, PaCO₂: arterial carbon dioxide tension, 6MWD: six-minute walk distance.
*resting PH defined as mPAP > 25 mm Hg or ECHO estimated sPAP > 40 mm Hg unless specified otherwise—see below:
^†PH was defined as estimated sPAP > 30 mm Hg without adding central venous pressure (CVP).
^‡Estimated sPAP without adding CVP. If CVP is assumed to be 5 mm Hg, this gives a sPAP of 37 mm Hg which amounts to a mPAP of 24 mm Hg based on the prediction equation 0.6 × sPAP + 2 = mPAP [113].
^§Calculated mPAP based on the prediction equation 0.6 × sPAP + 2 = mPAP [113].