Elevated pulmonary vascular resistance is associated with acute exacerbation admission in patients with chronic obstructive pulmonary disease-related pulmonary hypertension

BACKGROUND AND OBJECTIVE: Pulmonary hypertension (PH) is defined by elevated mean pulmonary arterial pressure (mPAP), and elevated pulmonary vascular resistance (PVR) reflects pulmonary vascular abnormalities. The clinical significance of severe PH in patients with chronic obstructive pulmonary disease (COPD) has not been fully elucidated. We aimed to investigate the predictive value of PVR for acute exacerbation (AE) admission in patients with COPD-related PH (COPD-PH). METHODS: We retrospectively analyzed COPD patients who underwent right heart catheterization (RHC) for the initial evaluation of PH from January 2019 to January 2023. These patients were classified into groups with or without PH, and further into non-severe or severe PH based on PVR. The clinical significance of PVR in predicting AE admission was analyzed. RESULTS: = 19.4; P < 0.0001). CONCLUSIONS: Elevated PVR serves as an independent predictor for acute exacerbation-related hospitalization in patients with COPD-PH: Specifically, a PVR >5 Wood units (defining severe PH) is independently associated with a significantly increased risk of admission due to AE. TRIAL REGISTRATION: The registration number(rhBNP-PH2022); Date of registration(June 30, 2022)(retrospectively registered).