Multidimensional clinical and paraclinical assessment of pulmonary hypertension in COPD: A retrospective observational study of 170 patients

Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder characterized by persistent airflow limitation and significant systemic consequences, representing a major cause of morbidity and mortality worldwide. Pulmonary hypertension (PH) is a frequent and severe complication of COPD, particularly in advanced stages of the disease, and is associated with reduced exercise capacity, increased functional impairment, and poorer prognosis. The complex pathophysiology of COPD-associated PH involves chronic hypoxia, pulmonary vascular remodeling, systemic inflammation, oxidative stress, and endothelial dysfunction. In this context, a multidimensional assessment integrating clinical, functional, and laboratory parameters is essential for improving risk stratification and optimizing therapeutic management. The present study aimed to perform an integrated evaluation of the clinical and paraclinical profile of patients with COPD and associated PH and to compare these findings with data reported in recent international literature. This retrospective observational study included 170 patients diagnosed with COPD who were evaluated in a tertiary care internal medicine department between November 2024 and October 2025. Patients were stratified into two groups according to the presence or absence of PH. Clinical evaluation, pulmonary function testing, transthoracic echocardiography, six-minute walk test (6MWT), functional classification according to the New York Heart Association, and laboratory assessment of inflammatory markers were performed. Comparative statistical analysis was used to evaluate differences between the two groups. Patients with COPD and PH demonstrated more severe respiratory functional impairment, reduced exercise tolerance, and higher functional class compared with those without PH. The PH group showed lower mean FEV1 values, shorter distances in the 6MWT, and higher levels of systemic inflammatory markers. Advanced GOLD stages and a higher prevalence of cardiovascular comorbidities were also more frequently observed in this group. PH significantly worsens the clinical and functional status of patients with COPD. A multidimensional evaluation combining clinical, functional, and biological parameters provides valuable information for risk stratification and may contribute to improving therapeutic strategies and prognostic assessment in patients with COPD-associated PH.