The value of measuring Exhaled Nitric Oxide in COPD with pulmonary hypertension.

<bold>Background:</bold> Alveolar epithelial cell destruction is more severe in patients with severe COPD and may influence NO production in the bronchial pathways, and the development of cor pulmonale in severe COPD may reduce Exhaled Nitric Oxide (FeNO), apparently as a reflection of endothelial damage (1). Purpose of the study. To study the practical utility of FeNO values in differential diagnosis of COPD with COPD accompanied by pulmonary hypertension (PAH). <bold>Methods:</bold> This was a prospective study. FeNO values were compared in 43 patients with COPD stage D with 28 patients with COPD stage D accompanied by PAH. FeNO was measured by an electrochemical nitric oxide analyzer (NIOX MINO). Echocardiographic estimates systolic pulmonary artery pressure (PSAP) in patients with COPD stage D. Independent sample t-test and analysis of variance–ANOVA were used to compare the means of continuous variables. Significance was defined as a p value of < 0.05. <bold>Results:</bold> The mean of FeNO in COPD without PAH is 11.4 (±6.7) and in COPD with PAH is 8.5 (±4.4). There is significant difference between them (t=2.0 p=0.04). The mean of FeNO according to the degree of PAH are respectively: in the mild stage it is 11.9 (±5.3), in the moderate stage it is 11.5 (±5.6) and in the severe stage it is 13.0 (±5.6), without statistically significant difference between them (ANOVA F-ratio=0.23 p=0.7) <bold>Conclusions:</bold> The measurement of lower levels of FeNO in patients with sever COPD can evaluate the damage of the vascular endothelium and indicates the realization of echo-Doppler to assessment PSAp 1. A. Rouhos. Clinical aspects of FENO in adults. June 2010