الفهرس 
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Abstract
Background: chronic obstructive pulmonary disease (COPD) is disease state characterized by progressive airflow limitation and is associated with an abnormal inflammatory response of the lungs to noxious particles or gases, primarily caused by cigarette smoking. Pulmonary hypertension primarily occurs in COPD patients with severe hypoxemia and fortunately it is typically mild. Hypoxemia increases pulmonary artery pressure (PAP) through hypoxic pulmonary vasoconstriction and vascular remodeling, but there is a correlation between lung function parameters and PAP, suggesting that factors other than airway obstruction and/or loss of alveolar surface may play a role in its etiology.
Objective: Identifying other factors other than resting hypoxemia contributing to pulmonary hypertension in COPD patients.
Patients and Methods: This study is a prospective study including 80 cases referred to Ain Shams university hospital presented with COPD defined using the standard criteria for chronic bronchitis. All patients will undergo spirometry with pre and post bronchodilator treatment and trans-thoracic echocardiography.
Results: The results showed that there was significant correlation between RVSP value and each of the following; age, duration of smoking, degree of airway obstruction and hemoglobin level which were all contributing to pulmonary hypertension in COPD patients. Among our 80 patients 18 had elevated RVSP value with mean age 54.15± 10.56 from which 5 patients had very severe obstructive pattern representing 27.8% of the study population, 16 patients with duration of smoking >25 years representing 88.9% of the study population and 6 patients with hemoglobin level >16gm/dl representing 33.3% of study population.
Conclusion: Our study suggests that pulmonary hypertension occurs frequently in stable outpatients with COPD without resting hypoxemia and that age, duration of smoking, low pre-bronchodilator FEV1 and hemoglobin value are all risk factors for pulmonary hypertension. Identifying pulmonary hypertension in patients with COPD is important because of its association with increased morbidity and mortality.