Exertional desaturation as a predictor of rapid lung function decline in COPD: Consider pulmonary embolic disease and pulmonary hypertension too

摘要

Kim et al. [1] report the potential predictive value of exertional desaturation in chronic obstructive pulmonary disease (COPD) patients for decline in lung function. There was no noted difference in exacerbations to account for the decline in lung function. The desaturator group had a lower baseline gas transfer, resting saturation, FEV_1 and body mass index and a higher BODE index and St George's Respiratory Questionnaire (SGRQ) score. Therefore, two of the other diagnostic possibilities to consider in the desaturator group would be pulmonary embolic disease and secondary pulmonary hypertension (with or without secondary atrial arrhythmias or P-wave dispersion), which would not be apparent on the volumetric CT scan unless the emboli were large and proximal or the pulmonary hypertension was severe, as suggested by the ratio of the pulmonary artery to the aorta.