Cardiopulmonary Exercise Testing In Chronic Obstructive Pulmonary Disease Patients With Pulmonary Hypertension Associated With Pulmonary Hypertension Evaluation

ObjectiveTo investigate the effects of pulmonary hypertension in patients with chronic obstructive pulmonary motion sickness endurance and ventilation effectiveness by cardiopulmonary exercise test(cardiopulmonary exercise testing, CPET), explore the clinical value of cardiopulmonary exercise test in the evaluation of COPD patients with pulmonary hypertension associated with pulmonary hypertension.MethodsSelect the Second Affiliated Hospital of Zhengzhou University, 65 cases of patients with stable respiratory medicine inpatient and outpatient GOLD?-?diagnosed with chronic obstructive pulmonary disease, including 46 male and 19 females, aged 55-78 years, mean(61.5 ± 5.3) years. According to echocardiography measured pulmonary artery systolic pressure(PASP) values were divided into two groups, 46 patients with pulmonary hypertension in patients with COPD associated referred to as the observation group [PASP?40mmHg(1mmHg?0.133kpa)], COPDwithout pulmonary hypertension the 41 patients referred to as the control group(PASP <40mm Hg). All enrolled patients for routine lung function at rest,echocardiography and symptoms of self-limited incremental CPET load detection,collected by the successive breathing respiratory exchange parameters.Results1.Observation group sex, age, body mass index [(21/9),(62.47 ± 9.99),(64.45 ±8.61)], and the control group of patients [(25/10),(64.45 ± 8.61),(24.31 ± 4.84)] no difference,(P> 0.05);2.Observe patients DLCO% pred(57.42 ± 23.65), PaO2(65.35 ± 8.24),significantly lower than the control group(89.43 ± 28.6),(78.21 ± 10.09), the difference was statistically significant(P <0.05); correlation analysis showed that the pulmonary artery pressure and DLCO% pred was a significant negative correlation(r=-0.883, P = 0.000).3.Observe the group of patients with pulmonary arterial pressure(PASP), right ventricular end-diastolic diameter(RVED) were(55.44 ± 16.39) mmHg,(32.47 ±6.53) mm, significantly higher than that(32.23 ± 4.29) mmHg and( 21.28 ± 1.88)mm, the difference was statistically significant(P <0.05). Observation group and control group LVED(mm), LVEF(%), RVEF(%) showed no difference(P> 0.05);Correlation analysis showed that pulmonary vein pressure and RVED was a significant positive correlation(r = 0.943, p = 0.000).4. Observation group patients VE @ peak, HR, VO2 / f @ AT, RER, PetCO2 @AT, VD / no VT with the control group of patients differences(P <0.05); VO2 max patients in the observation group, AT, VO2 / f @ Peak, peak load, PetCO2 @ peak,HRRmax, OUES, OUEP, OUE @ AT, significantly reduced PetCO2 @ peak compared with the control group, and the difference was statistically significant(P<0.05); VE patients in the observation group / VCO2-slop and Lowest-VE / VCO2 significantly increased compared with the control group, the difference was statistically significant(P <0.05); correlation analysis showed that the pulmonary artery pressure and VO2 max, OUEP was a significant negative correlation(r =-0.902,p = 0.000; r =-0.978, p = 0.000), and the VE / VCO2-slop, Lowest-VE / VCO2 was a significant positive correlation(r = 0.946, p = 0.000).5.Multivariate regression analysis showed that the effect of different parameters on the PASP following descending order: VE / VCO2-slop, VO2 max, Lowest-VE /VCO2, OUEP, OUES, RVED, DLCO% pred.ConclusionsChronic obstructive pulmonary disease associated with pulmonary hypertension endurance sports and ventilation effectiveness compared with COPD patients without pulmonary hypertension was significantly decreased compared with resting pulmonary function, echocardiography, CPET parameters correlated with pulmonary artery pressure maximum, suggesting that application CPET assess the severity of chronic obstructive pulmonary disease associated with pulmonary hypertension in patients with pulmonary hypertension have clinical value.