Pulmonary Arterial Pressure Response During Exercise in COPD: A Correlation with C-Reactive Protein (hsCRP)

Janos Varga1, 2, *, Attila Palinkas4, Imre Lajko1, Ildikó Horváth2, Krisztina Boda3, Attila Somfay1
1 Department of Pulmonology, University of Szeged, Deszk, Hungary
2 National Koranyi Institute for TB and Pulmonology, Budapest, Hungary
3 Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary
4 Department of Internal Medicine, Elisabeth Hospital, Hodmezovasarhely, Hungary

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© Varga et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Pulmonary Rehabilitation, National Koranyi Institute for TB and Pulmonology, No 1, Piheno Street, H-1121 Budapest, Hungary, Fax No: +3613913285, E-mail: varga@koranyi.hu



The non-invasive assessment of pulmonary haemodynamics during exercise provides complementary data for the evaluation of exercise tolerance in patients with COPD.


Exercise echocardiography in the semi-supine position was performed in 27 patients with COPD (C) with a forced expiratory volume in one second (FEV1) of 36±12% predicted and 13 age and gender-matched non-COPD subjects (NC). COPD patients also underwent cardiopulmonary exercise testing with gas exchange detection (CPET). Furthermore, serum high sensitive C-reactive protein (hsCRP), a marker of systemic inflammation, was also measured.


The maximal work rate (WRmax) and aerobic capacity (VO2peak) were significantly reduced (WRmax: 77±33 Watt, VO2peak: 50±14 %pred) in COPD. Pulmonary arterial systolic pressure (PAPs) was higher in COPD versus controls both at rest (39±5 vs. 31±2 mmHg, p<0.001), and at peak exercise (72±12 vs. 52±8 mmHg, p<0.001). In 19 (70%) COPD patients, the increase in PAPs was above 22 mmHg. The change in pressure (dPAPs) correlated with hsCRP (r2=0.53, p<0.0001) and forced vital capacity (FVC) (r2=0.18, p<0.001).


PAPs at rest and during exercise were significantly higher in COPD patients and correlated with higher hsCRP. This may indicate a role for systemic inflammation and hyperinflation in the pulmonary vasculature in COPD.

The study was registered at ClinicalTrials.gov webpage with NCT00949195 registration number.

Keywords: Chronic obstructive pulmonary disease, Exercise, HS-CRP, Pulmonary hypertension, Systemic inflammation.