Table 3.
Assessment of the Pulmonary Vascular Phenotype in COPD
| Clinical features |
| Exclusion of other causes of PH |
| ● Chronic thromboembolism: angio-CT, V-Q scintigraphy |
| ● Left heart disease: echocardiography, right heart catheterization |
| ● Sleep breathing disorders |
| Risk factors for PAH |
| ● HIV infection |
| ● BMPR2 mutations |
| ● Portal hypertension |
| ● Connective tissue disease |
| Pulmonary function testing |
| ● Forced spirometry |
| ● CO diffusing capacity (DLCO) |
| ● Arterial blood gases: PaO2 and PaCO2 |
| Imaging techniques |
| ● High-resolution CT scan: assessment of extent and severity of emphysema |
| Right heart catheterization |
| ● Mean PAP |
| ● Cardiac index |
| Cardiopulmonary exercise testing |
| ● Cardiovascular limitation pattern |
| ● Preserved ventilatory response |
| ● Gas exchange inefficiency: low end-tidal CO2, high VE/VCO2 slope |
| Circulating biomarkers |
| ● BNP or NT-proBNP |
Abbreviations: PH, pulmonary hypertension; angio-CT, computed tomography angiogram; V-Q, ventilation and perfusion; PAH, pulmonary arterial hypertension; HIV, human immunodeficiency virus; BMPR2, bone morphogenetic protein receptor type 2; PAP, pulmonary artery pressure; VE, minute ventilation; VCO2, carbon dioxide output; BNP, brain natriuretic peptide; NT-proBNP, N-terminal prohormone of brain natriuretic peptide.