Semin Respir Crit Care Med 2013; 34(05): 600-619
DOI: 10.1055/s-0033-1356548
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Pulmonary Hypertension Complicating Interstitial Lung Disease and COPD

Michael Y. Shino
1   Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
,
Joseph P. Lynch III
1   Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
,
Rajeev Saggar
2   Division of Pulmonary and Critical Care Medicine, Department of Medicine, Heart-Lung Institute, St. Joseph Hospital and Medical Center, Phoenix, Arizona
,
Fereidoun Abtin
3   Division of Thoracic Imaging and Intervention, Department of Radiological Sciences, UCLA Medical Center, Los Angeles, California
,
John A. Belperio
1   Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
,
Rajan Saggar
1   Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
› Author Affiliations
Further Information

Publication History

Publication Date:
13 September 2013 (online)

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Abstract

Pulmonary hypertension (PH) may complicate parenchymal lung disease, specifically interstitial lung diseases and chronic obstructive pulmonary disease, and uniformly increases the mortality risk. The epidemiology and degree of PH is variable and unique to the underlying lung disease. The clinician should exercise a high index of suspicion for PH complicating parenchymal lung disease especially given the nonspecific symptomatology and the limitations of echocardiography in this patient population. In general, PH-specific therapies in this setting have been poorly studied, with concern for increased shunting and/or ventilation/perfusion (V/Q) mismatch and resultant hypoxemia. A better understanding of the mechanisms underlying PH related to parenchymal lung disease may lead to novel pharmacological targets to prevent or treat this serious complication.