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Open Access Commentary

Chronic obstructive pulmonary disease phenotype desaturator with hypoxic vascular remodelling and pulmonary hypertension obtained by cluster analysis

Domenico Maurizio Toraldo1*, Mauro Minelli2, Francesco De Nuccio3 and Giuseppe Nicolardi3

Author Affiliations

1 “A. Galateo” Lung Disease Hospital, Rehabilitation Division, Regional Service Puglia, via A. C. Casetti n. 2, San Cesario di Lecce, 73100, ASL, Lecce, Italy

2 Director of the Operative Unit“IMID Centre” in Campi Salentina Hospital, ASL, Lecce, Italy

3 Laboratory of Human Anatomy, Department of Biological and Environmental Sciences and Technologies, University of Salento, Lecce, Italy

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Multidisciplinary Respiratory Medicine 2012, 7:39  doi:10.1186/2049-6958-7-39

Published: 5 November 2012

Abstract

Significant heterogeneity of clinical presentation and disease progression exists within chronic obstructive pulmonary disease (COPD). This article discusses and refines the concept of desaturator phenotypes in COPD with pulmonary hypertension (PH) obtained by cluster analysis and presents a pattern of phenotypic markers that could be used as a framework for future diagnosis and research. Nocturnal oxygen desaturation results in sleep disturbances which predispose to nocturnal cardiac dysrhythmias, PH and possibly nocturnal death, particularly during acute exacerbations. We assume that in patients with COPD at least two factors play a role in PH: the severity of pulmonary impairment, and the severity of systemic nocturnal hypoxaemia due to reduced pulmonary functions. Establishing a common language for future research will facilitate our understanding and management of such a disease. This knowledge could lead to different pharmacological treatments and other interventions directed at specific phenotypic groups.

Keywords:
Chronic obstructive pulmonary disease; Desaturator; Nocturnal hypoxaemia; Phenotypes; Pulmonary hypertension