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Related Experiment Video

Updated: May 20, 2025

Hemodynamic Characterization of Rodent Models of Pulmonary Arterial Hypertension

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Published on: April 11, 2016

Pulmonary hypertension associated with COPD: a phenotype analysis.

Mathilde Steger¹, Matthieu Canuet¹, Guillaume Martin¹

¹Chest Diseases Department, Nouvel hôpital civil, University Hospital of Strasbourg, Strasbourg, France.

ERJ Open Research

|March 25, 2025

Summary

Pulmonary hypertension in COPD patients shows diverse phenotypes, from severe emphysema to distinct pulmonary vascular changes. Understanding these COPD-PH phenotypes is crucial for tailored diagnosis and treatment strategies.

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Last Updated: May 20, 2025

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Area of Science:

Pulmonary Medicine
Cardiology
Radiology

Background:

Pulmonary hypertension (PH) in Chronic Obstructive Pulmonary Disease (COPD) presents varied phenotypes, complicating treatment.
This study categorizes COPD patients into three distinct groups based on PH severity and underlying pathology.

Purpose of the Study:

To characterize COPD patients with distinct phenotypes of pulmonary hypertension.
To differentiate between end-stage COPD with PH, mild-to-moderate pre-capillary PH-COPD, and a pulmonary vascular phenotype (PVP).

Main Methods:

Retrospective analysis of COPD patients who underwent right heart catheterisation between 2015 and 2022.
Inclusion of 81 patients in group 1 (end-stage COPD with PH), 37 in group 2 (mild-to-moderate PH-COPD), and 35 in group 3 (PVP).

Main Results:

Significant differences observed in clinical, functional, hemodynamic, and imaging characteristics across the three groups.
Group 1 exhibited marked lung hyperinflation and severe emphysema (median index 55%), unlike Group 3 with mild emphysema (median index 16%).
Chest CT scans confirmed emphysema severity: severe in Group 1, moderate in Group 2, and mild in Group 3 (p<0.0001).

Conclusions:

COPD-PH spans a spectrum from end-stage COPD with severe emphysema to PVP primarily due to vascular changes.
Phenotype/group 2 represents an intermediate state.
Quantitative emphysema thresholds may aid future diagnostic and management algorithms for PH-COPD phenotypes.