Chronic Obstructive Pulmonary Disease (COPD)
Conditions
Interventions
None listed
Sponsors
Nippon Medical School Hospital
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Adults aged between 20 and 80 years. Patients diagnosed with chronic obstructive pulmonary disease (COPD) by respiratory specialists according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. Clinically stable condition for at least 3 months, with no need for treatment modification. Underwent both echocardiographic and right heart catheterization (RHC) examinations for the evaluation of exertional dyspnea. Complete and analyzable clinical, echocardiographic, and hemodynamic data available.
Exclusion criteria
Exclusion criteria: Patients were excluded if they met any of the following criteria: Pulmonary hypertension (PH) caused by etiologies other than COPD (e.g., interstitial lung disease, pulmonary embolism). Left heart disease defined as left ventricular ejection fraction (LVEF) < 50% or moderate to severe valvular heart disease. Systemic inflammatory diseases or collagen vascular disorders. Pulmonary artery wedge pressure (PAWP) > 15 mmHg. Treatment with systemic vasodilators or calcium channel blockers, or recent use of these agents. Comorbid conditions unrelated to COPD that significantly limit physical activity (for example, neuromuscular or orthopedic disorders). Incomplete hemodynamic or echocardiographic data or missing essential parameters. Clinical features suggesting asthma or asthma COPD overlap (ACO), including: Bronchodilator reversibility in FEV1 greater than or equal to 200 mL, Blood eosinophil count greater than 150 cells per micro liter, History of atopy, or Serum IgE level greater than 170 IU per mL. Atrial fibrillation or significant arrhythmias that make time interval measurement difficult. Combined pulmonary fibrosis and emphysema (CPFE) defined as fibrotic changes occupying more than 10 percent of total lung field on high resolution computed tomography (HRCT). Patients with minimal paraseptal fibrosis or traction bronchiectasis involving less than 10 percent of the lung field were included.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Association between right ventricular isovolumetric relaxation time (IRT) measured by echocardiography and pulmonary vascular resistance index (PVRI) measured by right heart catheterization. The strength of the association will be evaluated using correlation coefficients (Pearson or Spearman) and linear regression analysis. | — |
Secondary
| Measure | Time frame |
|---|---|
| Association between IRT and unindexed pulmonary vascular resistance (PVR). Association between IRT and clinical parameters, including mMRC dyspnea score, 6-minute walk distance (6MWD), and treadmill exercise test (TMET) performance. Correlation between PVRI and %FEV1, %DLCO, and mean pulmonary arterial pressure (mPAP). Comparison of echocardiographic parameters (IRT, PAAcT, TEI index, etc) between COPD patients with and without pulmonary hypertension. Correlation between IRT and pulmonary function parameters (%DLCO, %FEV1). Association between IRT and hemodynamic variables obtained from right heart catheterization (mPAP, PAWP, CI, SvO2). Comparison of IRT values between patients with and without pulmonary hypertension (PH). | — |
Countries
Japan
Contacts
Public ContactYosuke Tanaka
Nippon Medical School Hospital Department of Respiratory Medicine
Outcome results
None listed