Clinical Value of FeNO for Pulmonary Hypertension Diagnosis in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Objective. To investigate the clinical value of fractional exhaled nitric oxide (FeNO) in the diagnosis of pulmonary hypertension (PH) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods. In this study, the medical records of AECOPD patients were retrospectively reviewed. The patients were divided into AECOPD and AECOPD + PH groups based on the absence or presence of PH. Moreover, FeNO and other indexes were compared between the two groups. The value of FeNO in diagnosing AECOPD with PH was determined using the ROC curve. Results. A total of 83 patients were enrolled (56 in the AECOPD group and 27 in the AECOPD + PH group). The level of FeNO was significantly lower in the AECOPD + PH group than in the AECOPD group (P=0.022). Moreover, FeNO level (25.22 & PLUSMN; 8.45 ppb) was higher in the mild PH subgroup than in the moderate (16.64 & PLUSMN; 5.67 ppb, P=0.005) or severe (11.75 & PLUSMN; 2.36, P=0.002) PH subgroups. FeNO level was positively correlated with C-reactive protein in AECOPD patients while negatively correlated with brain natriuretic peptide in the AECOPD + PH group. ROC analysis showed that the optimal cutoff value of FeNO in the diagnosis of AECOPD with PH was 24.5 ppb. Conclusion. FeNO level at admission can act as an indicator for PH diagnosis in AECOPD patients.

Automated summary

This study found that FeNO levels have clinical value in diagnosing PH in patients with AECOPD. FeNO levels were higher in patients with mild PH and were positively correlated with C-reactive protein in AECOPD patients while negatively correlated with brain natriuretic peptide in the AECOPD + PH group.