%0 Journal Article %A Rodrigo Torres-Castro %A Elena Gimeno-Santos %A Jordi Vilaró %A Marta Roqué-Figuls %A Jorge Moisés %A Luis Vasconcello-Castillo %A Tanya Orizaga %A Joan Albert Barberà %A Isabel Blanco %T Effect of pulmonary hypertension on exercise tolerance in patients with COPD: a prognostic systematic review and meta-analysis %D 2021 %R 10.1183/16000617.0321-2020 %J European Respiratory Review %P 200321 %V 30 %N 160 %X Background Pulmonary hypertension (PH) is a frequent complication in patients with COPD.Objective To determine if, in patients with COPD, the presence of PH decreases exercise tolerance.Methods We included studies that analysed exercise tolerance using a cardiopulmonary exercise test (CPET) in patients with COPD with PH (COPD-PH) and without PH (COPD-nonPH). Two independent reviewers analysed the studies, extracted the data and assessed the quality of the evidence.Results Of the 4915 articles initially identified, seven reported 257 patients with COPD-PH and 404 patients with COPD-nonPH. The COPD-PH group showed differences in peak oxygen consumption (V′O2peak), −3.09 mL·kg−1·min−1 (95% CI −4.74 to −1.43, p=0.0003); maximum workload (Wmax), −20.5 W (95% CI −34.4 to −6.5, p=0.004); and oxygen pulse (O2 pulse), −1.24 mL·beat−1 (95% CI −2.40 to −0.09, p=0.03), in comparison to the group with COPD-nonPH. If we excluded studies with lung transplant candidates, the sensitivity analyses showed even bigger differences: V′O2, −4.26 mL·min−1·kg−1 (95% CI −5.50 to −3.02 mL·kg−1·min−1, p<0.00001); Wmax, −26.6 W (95% CI −32.1 to −21.1 W, p<0.00001); and O2 pulse, −2.04 mL·beat−1 (95% CI −2.92 to −1.15 mL·beat−1, p<0.0001).Conclusion Exercise tolerance was significantly lower in patients with COPD-PH than in patients with COPD-nonPH, particularly in nontransplant candidates.The V′O2peak, Wmax and O2 pulse values were significantly lower in patients with COPD-PH than in patients with COPD-nonPH, particularly in nontransplant candidates https://bit.ly/3s5dtJ9 %U https://err.ersjournals.com/content/errev/30/160/200321.full.pdf