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Published on: February 20, 2017
Can FVC/DLCO predict pulmonary hypertension in patients with chronic obstructive pulmonary disease?
1Department of Pulmonary Medicine, University of Health Science, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey. sedabeyhansagmen@gmail.com.
Objective:
The aim of the study was to investigate pulmonary function parameters in patients who did and did not have pulmonary hypertension, and the roles of forced vital capacity (FVC)/diffusing capacity of the lungs for carbon monoxide (DLCO) and FVC/DLCO/alveolar volume (VA) values in patients with COPD accompanied by pulmonary hypertension.
Patients And Methods:
This study included patients with stable and advanced COPD (groups C and D), who presented to the Chest Diseases outpatient clinic at our hospital. Parameters of age and sex, use of long-term oxygen therapy at home, and pulmonary function parameters were evaluated. In addition, systolic pulmonary artery pressure (sPAP) was evaluated on a transthoracic echocardiogram (TTE). Patients were grouped according to TTE sPAP values > 36, and those with normal sPAP values. The pulmonary function parameters of the two groups were compared.
Results:
PAP was found to be high in 19 patients (33.33%) and normal in 38 patients (66.67%). The BMI of the group with high PAP (23.54 ± 4.18) was also lower, compared to the group with normal PAP (26.91 ± 4.58) (p=0.010). The FVC/DLCO ratio of the group with high PAP (1.88 ± 0.69) was found to be higher compared to the group with normal PAP (0.90 ± 0.19) (p<0.001). The mean FVC/DLCO/VA ratio was higher in the group with high PAP (1.30 ± 0.68) compared to the group with normal PAP (p=0.001). When determining the height of PAP, cut-off values were examined for FVC/DLCO and FVC/DLCO/VA ratios. When the cut-off value for the FVC/DLCO ratio was taken as 1.31, the sensitivity was 96.8%, the specificity was 97.37%, the PPV was 95.00%, and the NPV was 92.86%. When the cut-off value for the FVC/DLCO/VA ratio was taken as 1.09, the sensitivity was 68.42%, the specificity was 97.37%, the PPV was 100.0%, and the NPV was 86.05%.
Conclusions:
The FVC/DLCO and FVC/DLCO/VA ratios can be important to predict increased PAP in patients with COPD. Pulmonary function tests, which are performed as a routine, have gained importance in clinical practice for the detection of pulmonary hypertension in patients with COPD.
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