[Doppler echocardiography in the evaluation of pulmonary hypertension in chronic obstructive pulmonary disease]

Systolic pulmonary arterial pressure (PAPs) at rest and during submaximal exercise using bicycle ergometer was estimated in 80 patients with clinical stable obstructive pulmonary disease (COPD). Systolic pulmonary arterial pressure was estimated by using continuous Doppler from maximal velocity of the tricuspid regurgitant jet by applying the modified Bernoulli equation and regression: PAPs = 1.23 x 4 Vmax2-0.09 (mmHg). Pulmonary hypertension (PAPs (m) 30 mmHg at rest, or PAPs (o) 40 mmHg during the exercise) was registered in 56% of the patients with chronic obstructive pulmonary disease. Thirty percent of the patients (24/80) had mild degree latent pulmonary hypertension (PAPs (o) = 41-47 mmHg), and 26% (21/80) of the patients with COPD had mild to moderate manifest pulmonary hypertension (PAPs(m) = 33-47 mmHg). In 11 patients with manifest pulmonary hypertension (52%), a decrease of PAPs for 5 mmHg or more was registered after oxygen-test. These patients were grouped as responders. Systolic pulmonary arterial pressure at rest and during the exercise has best correlation with arterial PaO2 (r = -0.73 to -0.87), and out of parameters of pulmonary ventilation it has the best correlation with index FEF50/FVC (r = -0.49 to -0.68). By using continuous wave Doppler systolic pulmonary artery pressure was estimated in 84% of the patients with COPD (80/95). Fifteen patients were excluded from the study because of the bad echocardiographic window or inadequate Doppler tricuspid regurgitation signal.