[Noninvasive diagnosis of pulmonary hypertension in patients with COPD using regression and discriminant analysis].

Abstract

The evidence of elevated non-invasive parameters in prediction of pulmonary hypertension was examined in 168 patients with chronic obstructive pulmonary disease (COPD). Forced vital capacity (FVC), Tiffeneau-test (FEV1), oxygen partial pressure, x-ray ascertained diameter of right descending branch of pulmonary artery (RDB), myocardial scintigraphy, and right ventricular ejection fraction showed significant differences between patients with and without pulmonary hypertension. Neither of them alone allows prediction of pulmonary pressure exactly, only in combination non-invasive parameters are usable. In non-invasive diagnosis of catheterisation we suggest to use a regression function including FEV1, FVC and RDB by an ascertained specificity of 80% and sensitivity of 75%. To classify the patients according to normal and increased pulmonary artery pressure, FEV1, RDB and myocardial scintigraphy by a discriminant function with specificity/sensitivity of 80%, are relevant parameters. Accurate diagnosis of latent pulmonary hypertension requires right heart catheterisation. The domain of non-invasive diagnosis is screening and therapy monitoring of pulmonary hypertension, or if right heart catheterisation is contraindicated.