ArticleBMJ open respiratory research2026
Beyond PVR: dynamic physiologic assessment enhances prognostic evaluation in pulmonary hypertension associated with chronic obstructive pulmonary disease.
Article in BMJ open respiratory research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesPulmonary hypertension associated with chronic obstructive pulmonary disease (PH-COPD) is associated with poor outcomes, yet resting haemodynamics incompletely capture disease severity. We evaluated whether integrating submaximal cardiopulmonary exercise testing variables with transthoracic echocardiographic and pulmonary function test parameters improves prognostic assessment in PH-COPD beyond resting haemodynamics alone.
settingSingle-tertiary pulmonary vascular disease referral centre in the USA.
participants67 patients with PH-COPD who underwent right heart catheterisation and complementary non-invasive testing between 2019 and 2024. PRIMARY OUTCOME MEASURES: The primary outcome was a composite of heart failure hospitalisation or all-cause mortality.
methodsAssociations between physiologic variables and outcomes were assessed using Cox proportional hazards models and survival tree analysis.
resultsThe composite outcome occurred in 47.1% of patients over a median follow-up of 518 (229-897) days. Several non-invasive dynamic physiologic variables were associated with adverse outcomes, including lower gas exchange-derived pulmonary vascular capacitance (Gx
conclusionsDynamic exercise-derived physiologic markers provide prognostic information complementary to resting haemodynamic assessment in PH-COPD and may improve risk stratification across this heterogeneous population.
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