Pulmonary pressure increase during Acute Exacerbation in Chronic Obstructive Pulmonary Disease and clinical outcome
<bold>Background:</bold> Elevated pulmonary pressures can lead to right ventricular (RV) dysfunction, worsen respiratory status, and increase overall morbidity in chronic obstructive pulmonary disease (COPD) patients. Yet, little is known about the impact of right sided pressure changes during COPD exacerbations (AECOPD) on patient outcomes. <bold>Aim:</bold> To determine whether pulmonary pressures are elevated during AECOPD compared to stable phase and to investigate the association between tricuspid regurgitation (TR) gradient during AECOPD and days alive and out of hospital (DAOH). Methods This multicenter, prospective study of pulmonary pressures changes in patients with AECOPD and stable phase. Inclusion criteria were diagnosis of COPD and admission with AECOPD. Transthoracic echocardiography (TTE), including TR gradient, tricuspid annular plane systolic excursion (TAPSE), RV diameter, and right atrial parameters, was performed during AECOPD and stable phase. Associations with DAOH were explored using linear regression, and paired t-tests assessed pressure changes. Results: Of 250 patients, 232 underwent TTE during AECOPD, and 107 completed stable-phase follow-up. Reasons for incomplete follow-up included death (46), withdrawal (23), poor TTE quality (21), and unmeasurable TR gradients (35). TR gradient increased significantly during AECOPD, with a mean difference of 6.0 mmHg (95% CI: 2.5–9.6; p = 0.001), while TAPSE, RV diameter, and right atrial size showed no significant changes. Higher TR gradients during AECOPD correlated with lower DAOH (p = 0.023). Conclusion: Pulmonary pressures were significantly elevated during AECOPD.
Authors
- Christian B. Laursen (ORCID: https://orcid.org/0000-0003-1448-8986)
- Søren Pedersen (ORCID: https://orcid.org/0000-0001-5700-3948)
- Ema Rastoder
- Josefin Eklöf (ORCID: https://orcid.org/0000-0003-3739-7526)
- Jørn Carlsen
- Valdemar Rømer (ORCID: https://orcid.org/0000-0002-1814-7639)
- Emil Durukan (ORCID: https://orcid.org/0000-0001-9221-8944)
- Morten Sengeløv (ORCID: https://orcid.org/0000-0002-2139-8068)
- Elisabeth Bendstrup (ORCID: https://orcid.org/0000-0002-4238-6963)
- Julie Janner
- Helena Zander Wodschow (ORCID: https://orcid.org/0000-0002-8928-9730)
- Kristoffer Grundtvig Skaarup (ORCID: https://orcid.org/0000-0002-2690-7511)
- Diana Ackermann
- Tonny Studsgaard Petersen (ORCID: https://orcid.org/0000-0002-9974-2738)
- Caroline Hedsund (ORCID: https://orcid.org/0009-0003-4816-8638)
- Jens‐Ulrik Stæhr Jensen (ORCID: https://orcid.org/0000-0003-4036-0521)
- Lars Pedersen (ORCID: https://orcid.org/0000-0002-5950-652X)
- Mia Moberg (ORCID: https://orcid.org/0000-0002-0960-4260)
- Filip Soeskov Davidovski (ORCID: https://orcid.org/0000-0002-6642-416X)
- Casper Falster (ORCID: https://orcid.org/0000-0002-0389-5386)
- Ulrik Dixen (ORCID: https://orcid.org/0000-0002-0755-9400)
- Louise Lindhardt Toennesen (ORCID: https://orcid.org/0000-0003-0641-6288)
- Peter Kamstrup (ORCID: https://orcid.org/0000-0002-5499-7171)
- Hashmat Sayed Zohori Bahrami
- Magnus T. Jensen (ORCID: https://orcid.org/0000-0002-0544-5215)
- Maria Dons (ORCID: https://orcid.org/0000-0003-3506-6862)
- Alexander Jordan (ORCID: https://orcid.org/0000-0002-5684-9375)
- Tor Biering‐Sørensen (ORCID: https://orcid.org/0000-0003-4209-2778)
- Pradeesh Sivapalan (ORCID: https://orcid.org/0000-0002-8620-3655)
- Ditte Vesterlev
- Jens Dahlgaard Hove (ORCID: https://orcid.org/0000-0002-5600-5623)
Institutions
- University of Copenhagen (DK)
- Steno Diabetes Centers (DK)
- Odense University Hospital (DK)
- Bispebjerg Hospital (DK)
- Hvidovre Hospital (DK)
- Aarhus University Hospital (DK)
- Copenhagen University Hospital (DK)
- Gentofte Hospital (DK)
Publication Details
- Published
- 2025-09-27
- DOI
- https://doi.org/10.1183/13993003.congress-2025.pa3048
- Primary Topic
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Type
- article
- Field-Weighted Citation Impact
- 0.00