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Updated: Nov 7, 2025
Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
Published on: August 24, 2019
Effect of pulmonary hypertension on exercise tolerance in patients with COPD: a prognostic systematic review and
Rodrigo Torres-Castro1,2, Elena Gimeno-Santos1,3, Jordi Vilaró4
1Dept of Pulmonary Medicine, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
Background:
Pulmonary hypertension (PH) is a frequent complication in patients with COPD.
Objective:
To determine if, in patients with COPD, the presence of PH decreases exercise tolerance.
Methods:
We included studies that analysed exercise tolerance using a cardiopulmonary exercise test (CPET) in patients with COPD with PH (COPD-PH) and without PH (COPD-nonPH). Two independent reviewers analysed the studies, extracted the data and assessed the quality of the evidence.
Results:
Of the 4915 articles initially identified, seven reported 257 patients with COPD-PH and 404 patients with COPD-nonPH. The COPD-PH group showed differences in peak oxygen consumption (V'O2peak ), -3.09 mL·kg-1·min-1 (95% CI -4.74 to -1.43, p=0.0003); maximum workload (Wmax), -20.5 W (95% CI -34.4 to -6.5, p=0.004); and oxygen pulse (O2 pulse), -1.24 mL·beat-1 (95% CI -2.40 to -0.09, p=0.03), in comparison to the group with COPD-nonPH. If we excluded studies with lung transplant candidates, the sensitivity analyses showed even bigger differences: V'O2 , -4.26 mL·min-1·kg-1 (95% CI -5.50 to -3.02 mL·kg-1·min-1, p<0.00001); Wmax, -26.6 W (95% CI -32.1 to -21.1 W, p<0.00001); and O2 pulse, -2.04 mL·beat-1 (95% CI -2.92 to -1.15 mL·beat-1, p<0.0001).
Conclusion:
Exercise tolerance was significantly lower in patients with COPD-PH than in patients with COPD-nonPH, particularly in nontransplant candidates.
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