TY - JOUR
T1 - Pulmonary pressure increases during acute exacerbation in COPD and clinical outcome
AU - Rastoder, Ema
AU - Sivapalan, Pradeesh
AU - Hedsund, Caroline
AU - Kamstrup, Peter
AU - Biering-Sørensen, Tor
AU - Dons, Maria
AU - Bistrup Petersen, Trine Charlotte
AU - Davidovski, Filip Soeskov
AU - Skaarup, Kristoffer Grundtvig
AU - Sengeløv, Morten
AU - Durukan, Emil
AU - Vesterlev, Ditte
AU - Wodschow, Helena Zander
AU - Pedersen, Lars
AU - Eklöf, Josefin
AU - Vognsen, Anna Kubel
AU - Moberg, Mia
AU - Janner, Julie
AU - Toennesen, Louise Lindhardt
AU - Bahrami, Hashmat S Z
AU - Dixen, Ulrik
AU - Dahlgaard Hove, Jens
AU - Jensen, Magnus Thorsten
AU - Ackermann, Daniel Alexander
AU - Jordan, Alexander
AU - Rømer, Valdemar
AU - Sperling, Søren
AU - Bendstrup, Elisabeth
AU - Falster, Casper
AU - Laursen, Christian B
AU - Carlsen, Jørn
AU - Jensen, Jens-Ulrik Stæhr
PY - 2025/9
Y1 - 2025/9
N2 - BACKGROUND: Elevated pulmonary pressures can lead to right ventricular dysfunction, worsen respiratory status and increase overall morbidity in COPD patients. Yet, little is known about the impact of right-sided pressure changes during acute exacerbation in COPD (AECOPD) on patient outcomes. Our aim was to determine whether pulmonary pressures are elevated during AECOPD compared with the stable phase and to investigate the association between tricuspid regurgitation (TR) gradient during AECOPD and days alive and out of hospital (DAOH).METHODS: This was a multicentre, prospective study of pulmonary pressures changes in patients with AECOPD and stable-phase COPD. Inclusion criteria were diagnosis of COPD and admission with AECOPD. Transthoracic echocardiography (TTE), including TR gradient, tricuspid annular plane systolic excursion (TAPSE), right ventricular diameter and right atrial parameters, was performed during AECOPD and the stable phase.RESULTS: Of 250 patients, 232 underwent TTE during AECOPD and 107 completed stable-phase follow-up. Reasons for incomplete follow-up included death (n=46), withdrawal (n=23), poor TTE quality (n=21) and unmeasurable TR gradients (n=35). TR gradient increased significantly during AECOPD, with a mean difference of 6.0 (95% CI 2.5-9.6) mmHg, while TAPSE, right ventricular diameter and right atrial size showed no significant changes. Higher TR gradients during AECOPD correlated with lower DAOH.CONCLUSION: TR gradients were significantly elevated during AECOPD, suggesting that transient right-sided pressure spikes are associated with COPD exacerbations. However, the direction of this association remains unclear and further research is needed to determine whether right-sided pressure changes contribute to exacerbations or whether exacerbations themselves drive these pressure spikes.
AB - BACKGROUND: Elevated pulmonary pressures can lead to right ventricular dysfunction, worsen respiratory status and increase overall morbidity in COPD patients. Yet, little is known about the impact of right-sided pressure changes during acute exacerbation in COPD (AECOPD) on patient outcomes. Our aim was to determine whether pulmonary pressures are elevated during AECOPD compared with the stable phase and to investigate the association between tricuspid regurgitation (TR) gradient during AECOPD and days alive and out of hospital (DAOH).METHODS: This was a multicentre, prospective study of pulmonary pressures changes in patients with AECOPD and stable-phase COPD. Inclusion criteria were diagnosis of COPD and admission with AECOPD. Transthoracic echocardiography (TTE), including TR gradient, tricuspid annular plane systolic excursion (TAPSE), right ventricular diameter and right atrial parameters, was performed during AECOPD and the stable phase.RESULTS: Of 250 patients, 232 underwent TTE during AECOPD and 107 completed stable-phase follow-up. Reasons for incomplete follow-up included death (n=46), withdrawal (n=23), poor TTE quality (n=21) and unmeasurable TR gradients (n=35). TR gradient increased significantly during AECOPD, with a mean difference of 6.0 (95% CI 2.5-9.6) mmHg, while TAPSE, right ventricular diameter and right atrial size showed no significant changes. Higher TR gradients during AECOPD correlated with lower DAOH.CONCLUSION: TR gradients were significantly elevated during AECOPD, suggesting that transient right-sided pressure spikes are associated with COPD exacerbations. However, the direction of this association remains unclear and further research is needed to determine whether right-sided pressure changes contribute to exacerbations or whether exacerbations themselves drive these pressure spikes.
U2 - 10.1183/13993003.00169-2025
DO - 10.1183/13993003.00169-2025
M3 - Journal article
C2 - 40774812
SN - 0903-1936
VL - 66
JO - The European respiratory journal
JF - The European respiratory journal
IS - 3
M1 - 2500169
ER -