Pulmonary hypertension (PH) is a frequent complication in patients with COPD.

To determine if, in patients with COPD, the presence of PH decreases exercise tolerance.

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.

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 (W_max), –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); W_max, –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).

Exercise tolerance was significantly lower in patients with COPD-PH than in patients with COPD-nonPH, particularly in nontransplant candidates.

肺动脉高压 (PH) 是 COPD 患者的常见并发症。

以确定在 COPD 患者中，PH 的存在是否会降低运动耐量。

我们纳入了使用心肺运动试验 (CPET) 分析 COPD 伴 PH (COPD-PH) 和无 PH (COPD-nonPH) 患者运动耐量的研究。两名独立审查员分析了研究，提取了数据并评估了证据的质量。

在最初确定的 4915 篇文章中，有 7 篇报道了 257 名 COPD-PH 患者和 404 名 COPD-nonPH 患者。COPD-PH 组表现出峰值耗氧量 ( V ' _{O 2peak} ) 的差异，–3.09 mL·kg ^–1 ·min ^–1（95% CI –4.74 至 –1.43，p=0.0003）；最大工作负荷 (W _max )，–20.5 W（95% CI –34.4 至 –6.5，p=0.004）；与 COPD-nonPH 组相比，氧脉搏（O ₂脉搏）–1.24 mL·beat ^–1（95% CI –2.40 至 –0.09，p=0.03）。如果我们排除肺移植候选者的研究，则敏感性分析显示出更大的差异：V ' _{O 2} , –4.26 mL·min ^–1·kg ^–1（95% CI –5.50 至 –3.02 mL·kg ^–1 ·min ^–1，p<0.00001）；W_最大值，–26.6 W（95% CI –32.1 至 –21.1 W，p<0.00001）；O ₂脉搏，–2.04 mL·beat ^–1（95% CI –2.92 至 –1.15 mL·beat ^–1，p<0.0001）。

COPD-PH 患者的运动耐量显着低于 COPD-nonPH 患者，特别是在非移植候选人中。