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Several causal factors have been proposed&#46; On one hand&#44; increased ventilatory requirements and abnormal dynamic ventilatory mechanics<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">7</span></a> are thought to be the main limiting factor&#44; although peripheral muscle weakness<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">8</span></a> and right ventricular diastolic function<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">9</span></a> have also shown to limit exercise capacity in COPD patients&#46; Moreover&#44; the presence of PH has been hypothesized to further decrease exercise tolerance&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">3&#44;10</span></a> It is necessary to characterize pulmonary hemodynamics in patients with moderate to severe COPD-PH in order to improve their management and to choose appropriate rehabilitation strategies&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Several studies have attempted to clarify whether the exercise limitation in COPD patients with PH is primarily due to the ventilatory impairment or to the vascular component with contradictory results&#46; Sims et al&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">10</span></a> found that in patients with severe COPD the presence of PH was associated with lower distance covered in the six-minute walk test &#40;6MWT&#41;&#44; regardless of pulmonary function&#44; anthropometric or demographic characteristics&#46; Also&#44; they showed that higher pulmonary arterial pressure &#40;PAP&#41; was associated with lower exercise capacity&#46; More recently&#44; the presence of PH was found to worsen maximal exercise capacity in a group of severe COPD patients&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">11</span></a> However&#44; there are also opposite studies suggesting that exercise impairment is due&#44; basically&#44; to the ventilatory limitation&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">12&#8211;15</span></a> The majority of previous studies present some limitations&#44; such as a selective sample only including severe COPD patients candidates for lung transplantation&#44;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">12</span></a> small sample size<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">14</span></a> or inaccurate definition of PH&#44;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">15</span></a> that might complicate getting clear conclusions&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The 6th World Symposium on Pulmonary Hypertension &#40;WSPH&#41; &#8220;encourage cardiopulmonary exercise test &#40;CPET&#41; for a more elaborate distinction between pulmonary versus circulatory limitation&#8221; with the aim to discriminate between different groups of PH&#46; Specifically between the group 1 &#40;pulmonary arterial hypertension&#44; PAH&#41; with a predominant cardiovascular profile &#40;exhausted circulatory reserve&#41; versus the group 3 with a predominant obstructive&#47;restrictive profile &#40;exhausted ventilatory reserve&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">16</span></a> This distinction arise from the study by Boerrigter et al&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">17</span></a> who showed that COPD patients with severe PH &#40;mean PAP &#8805;40<span class="elsevierStyleHsp" style=""></span>mmHg&#41; had an exhausted circulatory reserve at the end of exercise with a reduced slope of the cardiac output&#47;oxygen consumption ratio&#44; low mixed venous oxygen saturation and low arterial partial pressure of CO<span class="elsevierStyleInf">2</span> &#40;PaCO<span class="elsevierStyleInf">2</span>&#41;&#44; whilst the breathing reserve was preserved&#46; On the other hand&#44; COPD patients with moderate PH or without PH showed increased PaCO<span class="elsevierStyleInf">2</span> and exhaustion of the breathing reserve at the end of the exercise&#44; whereas the circulatory reserve was maintained&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">17</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Therefore&#44; we aimed to determine whether in a cohort of stable COPD patients the presence of PH is associated with reduced exercise tolerance&#44; as assessed by maximal and submaximal exercise tests&#44; and worse quality of life&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Design and setting</span><p id="par0030" class="elsevierStylePara elsevierViewall">This was a cross-sectional study comparing baseline data of Caucasian patients with COPD recruited and assessed at the Hospital Clinic &#40;Barcelona&#44; Spain&#41;&#46; Briefly&#44; COPD candidates referred to the pulmonary rehabilitation &#40;PR&#41; service of our hospital were screened for PH&#46; Those with PH were included in the SILD-COPD randomized double-blinded controlled trial &#40;NCT 01055405&#41;&#46; Patients without PH followed the standard PR program of our Institution&#46; We followed the STROBE guidelines&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">18</span></a> All patients understood&#44; agreed&#44; and signed the informed consent approved by the institutional review boards at Hospital Clinic &#40;Barcelona&#44; Spain&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Participants</span><p id="par0035" class="elsevierStylePara elsevierViewall">Adult patients aged between 40 and 80 years with a diagnosis of COPD according to the Global Initiative for Chronic Obstructive Lung Disease &#40;GOLD&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">1</span></a> clinically stable with optimized pharmacological treatment&#44; without a history of lower respiratory tract infection and&#47;or COPD exacerbation within 6 weeks prior to evaluation were assessed for PR&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The presence of associated PH was assessed using Doppler echocardiography in all patients&#46; PAP was considered abnormally increased when the maximum tricuspid regurgitation velocity was greater than 2&#46;7<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleHsp" style=""></span>s<span class="elsevierStyleSup">&#8722;1</span>&#44; which is equivalent to an estimated systolic PAP<span class="elsevierStyleHsp" style=""></span>&#62;34<span class="elsevierStyleHsp" style=""></span>mmHg<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">19&#44;20</span></a> calculated using Bernoulli&#39;s equation&#44; assuming a right atrial systolic pressure of 5<span class="elsevierStyleHsp" style=""></span>mmHg&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">21</span></a> In patients who had been subjected to right heart catheterization &#40;RHC&#41; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#41;&#44; we considered a definitive diagnosis of PH when mean PAP was &#8805;25<span class="elsevierStyleHsp" style=""></span>mmHg&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">19</span></a> We only included patients with PH from group III&#44; meaning PH due to lung diseases and&#47;or hypoxia&#46; Other potential causes of PH&#44; such as chronic thromboembolic pulmonary hypertension or left heart disease &#40;systolic function and valve diseases&#41;&#44; were discarded&#44; as well as the previous history of ischemic or mitral or aortic valve diseases&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Evaluation</span><p id="par0045" class="elsevierStylePara elsevierViewall">The following descriptive variables were assessed&#58; socio-demographic data &#40;age&#44; sex&#44; smoking status&#41;&#44; lung function &#40;forced spirometry&#44; lung volumes&#44; diffusing capacity of the lungs for carbon monoxide &#40;DLCO&#41; and arterial blood gases breathing room air&#41;&#46; Also&#44; health-related quality-of-life was assessed by the Spanish version of the St George&#39;s Respiratory Questionnaire &#40;SGRQ&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">22</span></a> and dyspnea symptoms were measured by the modified Medical Research Council &#40;mMRC&#41; dyspnea scale&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">23</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">All patients were evaluated with an incremental CPET&#44;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">24</span></a> a constant work-load exercise test &#40;to measure endurance time&#41; &#40;CWET&#41;&#44; both conducted on a cycle ergometer &#40;Lode Corival CEPT mod&#58; 960900&#44; Groningen&#44; The Netherlands&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">25</span></a> and a 6MWT&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">26</span></a> In order to ensure a reliable endurance time&#44; during the constant work-rate exercise COPD patients with PH performed the test at the 70&#37; of the peak work-load achieved in the incremental test&#44; whereas COPD patients without PH carried out the test at the 80&#37; of the peak work-load&#46; Patients on long-term oxygen therapy were assessed without oxygen during the evaluation tests on the cycle ergometer &#40;PH group&#44; <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>18&#41; but performed the 6MWT under oxygen&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Statistics</span><p id="par0055" class="elsevierStylePara elsevierViewall">Quantitative variables were expressed as mean and standard deviation &#40;SD&#41; or median and Interquartile Range &#40;IQR&#58; 25th&#59; 75th percentiles&#41;&#46; Qualitative variables were described as frequencies and percentages &#40;<span class="elsevierStyleItalic">n</span>&#44; &#37;&#41;&#46; Differences between groups were evaluated using Student&#39;s <span class="elsevierStyleItalic">t</span>-test for normally distributed variables&#44; Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test for non-parametric variables&#44; or Fisher&#39;s exact test for comparing proportions&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">We estimated the odds ratio &#40;OR&#41; and their 95&#37; confidence intervals &#40;95&#37; CI&#41; from logistic regression model to explore the effect of PH on exercise capacity in COPD patients independently of other variables such as &#40;i&#41; lung function and &#40;ii&#41; socio-demographic characteristics&#46; Other factors were introduced in the analyses were selected based on statistical significance in the univariable analyses&#44; and their potential physiological relationship with the presence of PH&#46; Cut-off points were dichotomized based on the median value of the distribution for distance walked in the 6MWT&#44; peak oxygen consumption &#40;VO<span class="elsevierStyleInf">2</span>peak&#41; and SGRQ score&#46; In these comparisons&#44; all patients were considered&#46; Different models for the effect of PH adjusted by age&#44; BMI&#44; forced expiratory volume in the first second &#40;FEV<span class="elsevierStyleInf">1</span>&#41;&#37; predicted&#44; DLCO&#44; partial pressure of O<span class="elsevierStyleInf">2</span> in arterial blood &#40;PaO<span class="elsevierStyleInf">2</span>&#41;&#44; mMRC&#44; and SGRQ score were were performed and the results from logistic regression were presented as OR &#40;95&#37; CI&#41;&#46; The level of significance was set at the standard two-sided level of 5&#37;&#46; All the analyses were performed using the statistical package SPSS version 25&#46;0 software &#40;IBM Corporation&#44; Armonk&#44; NY&#44; USA&#41;&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Results</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Patient&#39;s characteristics</span><p id="par0065" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> describes the overall flow-chart of patients&#46; We present data of the 174 patients analyzed who were fully assessed&#44; 109 with COPD without PH &#40;non-PH COPD group&#41;&#58; 90&#37; male&#44; 68&#40;8&#41; years old and FEV<span class="elsevierStyleInf">1</span> of 51&#40;16&#41;&#37; of predicted value&#59; and&#44; 65 with COPD and associated PH &#40;COPD-PH group&#41;&#58; 90&#37; male&#44; 66&#40;8&#41; years old and FEV<span class="elsevierStyleInf">1</span> of 32&#40;11&#41;&#37; predicted&#46; Clinical characteristics are displayed in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; All four GOLD stages are presented in both groups&#59; although 48&#37; of patients of the COPD-PH group were classified as GOLD 4&#44; whereas 46&#37; in the non-PH COPD group were classified as GOLD 2&#46; Globally&#44; COPD-PH patients showed worse clinical and lung function characteristics&#46; There was no significant difference in body mass index &#40;BMI&#41; between groups&#59; although&#44; two subjects with PH had a BMI below 18&#46;5<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> &#40;underweight&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Exercise tolerance</span><p id="par0070" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the response to CPET and 6MWT&#46; COPD-PH patients showed lower exercise capacity both at maximal &#40;CPET&#41; and submaximal &#40;6MWT&#41; tests&#46; In addition&#44; COPD-PH patients had shorter endurance time than the non-PH COPD group &#40;265&#40;113&#41; s&#44; and 295&#40;164&#41; s&#44; respectively&#41; despite being assessed at a 10&#37; lower work-load&#46; The difference in work-load prevented statistical comparison&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">The logistic regression model showed that the presence of PH was associated with poor exercise capacity&#44; adjusted by lung function&#44; age&#44; and BMI&#46; In the analysis&#44; the group of patients with a distance covered in the 6MWT below the median value &#40;&#60;450<span class="elsevierStyleHsp" style=""></span>m&#41; show an OR of 5&#46;41&#46; The OR in the adjusted models by age&#44; BMI&#44; FEV<span class="elsevierStyleInf">1</span>&#37;pred&#44; and PaO<span class="elsevierStyleInf">2</span> were statistically significant&#46; In the VO<span class="elsevierStyleInf">2</span>peak analysis &#40;&#60;60&#37;pred&#41; the group with PH shows an OR of 7&#46;91 &#40;3&#46;74&#59; 16&#46;73&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; The OR in the adjusted models by age&#44; BMI&#44; FEV<span class="elsevierStyleInf">1</span>&#37;pred&#44; and PaO<span class="elsevierStyleInf">2</span> were statistically significant&#46; In the quality of life analysis &#40;SGRQ score<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>42&#41; the group with PH shows an OR of 2&#46;1 &#40;1&#46;02&#59; 4&#46;36&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;046&#41;&#46; The OR in the adjusted models by age&#44; BMI&#44; and FEV<span class="elsevierStyleInf">1</span>&#37;pred were statistically significant &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Discussion</span><p id="par0080" class="elsevierStylePara elsevierViewall">The main finding of this study is that the presence of PH was associated with impaired exercise capacity in COPD patients adjusted for age&#44; BMI and airflow obstruction&#46; Patients with increased PAP reached lower maximal work-load while cycling&#44; presented lower VO<span class="elsevierStyleInf">2</span>peak&#44; covered less distance in the 6MWT&#44; developed greater O<span class="elsevierStyleInf">2</span> desaturation during exercise&#44; and had more dyspnea and worse quality of life&#46; Although the ventilatory impairment and the reduced PaO<span class="elsevierStyleInf">2</span> are important factors limiting exercise in COPD patients&#44; the multivariate analysis shows that PH per se has a detrimental effect on exercise capacity for a given degree of ventilatory impairment&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Although these results are expected&#44; it is necessary to characterize pulmonary hemodynamics in patients with moderate to severe COPD and to analyze their response to exercise to choose better therapeutic strategies&#44; especially for those who are candidates for pulmonary rehabilitation&#46; In keeping with this&#44; previous studies have shown that pulmonary rehabilitation improve exercise capacity in patients with COPD-PH but concomitant treatment with pulmonary vasodilators do not improve the results of the pulmonary rehabilitation program in exercise tolerance&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">27</span></a> Additionally the most recent Task Force on Pulmonary Vascular Diseases also recommended pulmonary rehabilitation in patients with COPD and moderate PH&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">16</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">Patients with COPD-PH showed a profile of exhausted circulatory reserve during exercise&#46; The oxygen pulse&#44; that provides an estimate of left ventricle stroke-volume changes during exercise&#44;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">28</span></a> was significantly lower in the COPD-PH group &#40;54&#37; predicted&#41; than in COPD patients without PH &#40;73&#37; predicted&#41;&#46; These results are in line with the study by Boerrigter et al&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">17</span></a> who showed in their patients with severe PH an exhausted circulatory reserve at the end of the exercise while the breathing reserve was maintained&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">17</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Exercise limitation in patients with COPD was initially associated as a direct consequence of airway obstruction&#44; but this association has shown only a weak relation&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">29</span></a> The dynamic hyperinflation leads by the limitation of expiratory flows has been associated with functional weakness of the inspiratory muscles and with the restriction of thoracic expansion of normal tidal volume during exercise&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">30</span></a> On the other hand&#44; changes in skeletal muscle are associated with exercise limitation&#46;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">31</span></a> In the case of the presence of PH in patients with COPD&#44; the literature describes the limited exercise capacity in patients with COPD and abnormal pulmonary artery pressure&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">15</span></a> Our group showed differences between lung function&#44; but when correcting by this factor&#44; it still appears this difference in exercise capacity&#44; that can be explained by the increase of PAP&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">We observed that the presence of PH decreased oxygen uptake and oxygen pulse&#44; in addition to the ventilatory impairment typically observed in COPD patients&#46; Based on the Fick principle&#44; O<span class="elsevierStyleInf">2</span> pulse depends on both stroke volume and arteriovenous oxygen difference &#40;Ca-vO<span class="elsevierStyleInf">2</span>&#41;&#46; For the cardiovascular nature of PH&#44; these patients have demonstrated alterations in stroke volume&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">32</span></a> On the other hand&#44; abnormalities on arterial blood gases have been described as playing a role in exercise intolerance&#46;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">33</span></a> In patients with PH&#44; hypoxemia accelerates the early occurrence of lactic acidosis increasing the ventilatory drive &#40;by stimulation of the carotid bodies&#41; contributing to an excessive increase in VE during exercise&#46;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">34</span></a> This is another contributing factor for the reduction in exercise tolerance in our patients&#44; reproduced at both exercise tests&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Cuttica et al&#46;&#44; in a retrospective analysis of almost 5000 patients with advanced COPD&#44; candidates for lung transplantation&#44; reported that PH of any cause resulted in significant functional impairment measured by 6MWT and this result was associated with an increased risk of mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">3</span></a> Likewise&#44; Sims et al&#46;&#44; in 362 patients with severe COPD who were evaluated for lung transplantation&#44; demonstrated that higher values of mPAP were associated with impaired exercise tolerance measured by 6MWT&#44; independently of the severity of the airflow obstruction&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">10</span></a> Our results are in line with these previous reports in a population of patients less severely impaired&#59; we also found that the 6<span class="elsevierStyleHsp" style=""></span>min walk distance &#40;6MWD&#41; in our group with COPD-PH was about 100<span class="elsevierStyleHsp" style=""></span>m lower than in the group without PH &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; Contrasting with these findings&#44; the 6MWD did not differ in other similar studies although evaluating a smaller sample of patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">11&#44;12&#44;14</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">To overcome these discrepancies&#44; in our study we assessed comprehensively exercise tolerance by using maximal and submaximal exercise tests&#46; We confirmed the impairment in exercise capacity in the COPD-PH group also in the CPET&#44; the gold standard measurement for exercise capacity&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">In our population&#44; the VO<span class="elsevierStyleInf">2</span>peak at the CPET was 33&#37; lower in the group with PH&#44; which is in line with previous studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">11&#44;15</span></a> Although this finding could be due to lower FEV<span class="elsevierStyleInf">1</span> in the COPD-PH group&#44; in the model adjusted by the FEV<span class="elsevierStyleInf">1</span> value&#44; the probability of having a VO<span class="elsevierStyleInf">2</span>peak<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>60&#37; predicted was 3&#46;5 higher in the COPD-PH group than in the non-PH COPD group&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Similarly&#44; Vonbank et al&#46;&#44; showed a significant decrease of 25&#37; in VO<span class="elsevierStyleInf">2</span>peak in COPD patients with PH&#44; as compared with patients without PH&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">15</span></a> Thirapatarapong et al&#46; also showed a reduction of 16&#37; in VO<span class="elsevierStyleInf">2</span>peak in COPD-PH patients&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">11</span></a> Of note&#44; in both studies&#44; there were no differences in the severity of airflow obstruction between groups&#46; In contrast&#44; other studies did not find a significant difference in VO<span class="elsevierStyleInf">2</span>peak when comparing COPD-PH with non-PH COPD patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">12&#44;35</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">In our study&#44; the maximum workload achieved at the CPET was significantly lower in the COPD-PH group than in the non-PH group&#46; This is in line with Thirapatarapong et al&#46;&#44; who found significant difference in severe COPD patients &#40;21&#40;15&#41;&#37; predicted for COPD vs&#46; 15&#40;9&#41;&#37; predicted COPD-PH&#41; and Skjorten et al&#46;&#44; who studied 98 patients with a broad range of airway obstruction &#40;72&#40;31&#41; watts for COPD vs 40&#40;21&#41; watts for COPD-PH&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">11&#44;35</span></a> However&#44; Holverda et al&#46;&#44; Vonbank et al&#46;&#44; Pynnaert et al&#46;&#44; and Adir et al&#46; did not find any difference&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">12&#8211;15</span></a> Furthermore&#44; our results are more in line with the mechanistic explanation for PH because this loss of lung vasculature and distensibility is responsible for limiting exercise capacity&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">In this type of patients&#44; it is very critical the evaluation of the quality of life or multidimensional index like BODE index&#46;<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">36</span></a> Both measurements include the assessment of exercise tolerance and&#44; we found a significant difference in both outcomes in the COPD-PH group &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Although these patients should be characterized with objective evaluations&#44; we should not forget that patients are concerned about their symptoms and how these affect their quality of life&#44; so they should be incorporated in the evaluation of the exercise capacity to explore the interaction between physical performance and quality of life&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Furthermore&#44; patient&#39;s characteristics showed differences in pulmonary function&#44; dyspnea and quality of life between COPD-PH and non-PH COPD group&#46; These differences might explain&#44; in part&#44; the difference in maximum workload or VO<span class="elsevierStyleInf">2</span>peak between the groups&#46; However&#44; we applied a logistic regression model with the objective to adjust important variables that influence during exercise&#44; such as age&#44; BMI&#44; and very important in respiratory patients&#44; FEV<span class="elsevierStyleInf">1</span>&#37;pred&#46; These models were applied in submaximal &#40;6MWD<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>450<span class="elsevierStyleHsp" style=""></span>m&#41; and maximal &#40;VO2peak<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>60&#37; pred&#41; exercise tests&#44; and in all these models&#44; we found differences in exercise capacity between both groups&#46; All these findings may suggest that the presence of PH plays an important role in limiting exercise capacity&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">The characterization of pulmonary hemodynamics and exercise tolerance in patients with COPD-PH can contribute to improving their management&#44; especially in the rehabilitation strategies&#46; Recently&#44; the European Respiratory Society &#40;ERS&#41; and the American College of Chest Physicians had developed guidelines for exercise in PH<a class="elsevierStyleCrossRefs" href="#bib0385"><span class="elsevierStyleSup">37&#44;38</span></a>&#59; particularly&#44; the ERS declares that the supervised exercise training may improve right ventricular function and pulmonary hemodynamics in patients with stable PH&#46; Improved hemodynamics may contribute to an increase in exercise capacity and quality of life of patients&#46; Unlike other chronic respiratory diseases&#44; PH requires strict supervision of exercise in specialized centers&#44; so the characterization of patients is essential in order to establish the most beneficial and least risky programs for each one&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">This study has some limitations that ought to be disclosed&#46; The first limitation of the study refers to the inclusion rates&#44; which were different by the presence&#47;absence of PH &#8211; this is&#44; of course&#44; important in assessing the risk of bias&#46; Secondly&#44; PH was assessed mostly through echocardiography&#46; Although RHC is an invasive test not recommended for routine assessment in COPD patients&#44; non-invasive measurement of PAP has shown good correlation with RHC<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">39&#44;40</span></a> and echocardiography is an acceptable screen for PH&#46; Thirdly&#44; in the context of COPD&#44; pulmonary hypertension may involve the left heart &#40;diastolic dysfunction possibly secondary to hyperinflation&#44; associated systolic dysfunction&#41; but&#44; unfortunately&#44; in our study&#44; we could not exclude diastolic dysfunction in all patients &#40;only in the 21&#37; that had a RHC&#41;&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Finally&#44; the decision to lower 10&#37; the load in the constant-work test for PH patients precluded us to compare both groups statistically&#46; Still&#44; COPD-PH group reached shorter endurance time&#44; and we can argue that with a 10&#37; more of work-load the difference might have been significantly greater&#46; We consider that endurance time is a very useful outcome to compare the results of an intervention such as a pulmonary rehabilitation program&#44; especially in patients with PH because it reflects the resistance of the general musculature&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conclusions</span><p id="par0155" class="elsevierStylePara elsevierViewall">In conclusion&#44; PH in COPD patients impairs their exercise tolerance in maximal and submaximal tests and demonstrated a detrimental effect per se&#44; irrespective of age&#44; BMI&#44; FEV<span class="elsevierStyleInf">1</span>&#37;pred and PaO<span class="elsevierStyleInf">2</span>&#46; Pulmonary hemodynamics should be considered to better understand the exercise intolerance in patients with moderate to severe COPD and associated PH to improve their management&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Funding</span><p id="par0170" class="elsevierStylePara elsevierViewall">The study was supported by grants from the Fondo de Investigaci&#243;n Sanitaria&#44; Instituto de Salud Carlos III &#40;PI17&#47;1515&#41;&#44; Fondo Europeo de Desarrollo Regional &#40;FEDER&#41;&#44; Uni&#243;n Europea&#46; &#8220;Una manera de hacer Europa&#8221; Sociedad Espa&#241;ola de Neumolog&#237;a y Cirug&#237;a Tor&#225;cica &#40;SEPAR&#41; and Societat Catalana de Pneumologia &#40;SOCAP&#41;&#46; Elena Gimeno-Santos had personal funding from Instituto de Salud Carlos III&#44; Sara Borrell contract &#40;Acci&#243;n Estrat&#233;gica en Salud 2013&#8211;2016&#41;&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conflict of interest</span><p id="par0160" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
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            1 => "Chronic obstructive pulmonary disease"
            2 => "Exercise tolerance"
            3 => "Cardiopulmonary exercise test"
            4 => "Six-minute walk test"
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          "titulo" => "Abbreviations"
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          "palabras" => array:18 [
            0 => "6MWT"
            1 => "COPD"
            2 => "CPET"
            3 => "CWET"
            4 => "DLCO"
            5 => "FEV1"
            6 => "GOLD"
            7 => "IQR"
            8 => "mMRC"
            9 => "OR"
            10 => "PaCO<span class="elsevierStyleInf">2</span>"
            11 => "PaO<span class="elsevierStyleInf">2</span>"
            12 => "PAH"
            13 => "PAP"
            14 => "PH"
            15 => "PR"
            16 => "SGRQ"
            17 => "WSPH"
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          "palabras" => array:5 [
            0 => "Hipertensi&#243;n pulmonar"
            1 => "Enfermedad pulmonar obstructiva cr&#243;nica"
            2 => "Tolerancia al ejercicio"
            3 => "Prueba de ejercicio cardiopulmonar"
            4 => "Prueba de marcha de seis minutos"
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      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introduction</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The impact of pulmonary hypertension &#40;PH&#41; on exercise tolerance in chronic obstructive pulmonary disease &#40;COPD&#41; has not been fully elucidated&#46; It is necessary to characterize pulmonary hemodynamics in patients with moderate to severe COPD in order to improve their management&#46; The aim of the study was to determine whether in COPD the presence of PH is associated with reduced exercise tolerance in a cohort of stable COPD patients&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Cross-sectional analysis of 174 COPD patients clinically stable&#58; 109 without PH and 65 with PH &#40;COPD-PH&#41;&#46; We assessed socio-demographic data&#44; lung function&#44; quality of life&#44; dyspnea&#44; cardiopulmonary exercise testing &#40;CPET&#41;&#44; constant workload endurance time &#40;CWET&#41;&#44; and six-minute walk test &#40;6MWT&#41;&#46; We elaborated a logistic regression model to explore the impact of PH on exercise capacity in COPD patients&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">COPD-PH patients showed lower exercise capacity both at maximal &#40;CPET&#41; &#40;43&#40;20&#41; versus 68&#40;27&#41; Watts and 50&#40;19&#41;&#37; versus 71&#40;18&#41;&#37; predicted peak oxygen consumption &#40;VO<span class="elsevierStyleInf">2</span>peak&#41;&#44; COPD-PH and COPD&#44; respectively&#41;&#44; and at submaximal tests &#40;6MWT&#41; &#40;382&#40;94&#41; versus 486&#40;95&#41; m&#41;&#46; In addition&#44; the COPD-PH group had lower endurance time than the non-PH COPD group &#40;265&#40;113&#41; s and 295&#40;164&#41; s&#44; respectively&#41;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The presence of PH is an independent factor that impairs exercise capacity in COPD&#46;</p></span>"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introducci&#243;n</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">El impacto de la hipertensi&#243;n pulmonar &#40;HTP&#41; en la tolerancia al ejercicio en la enfermedad pulmonar obstructiva cr&#243;nica &#40;EPOC&#41; no se ha dilucidado en su totalidad&#46; Es necesario caracterizar la hemodin&#225;mica pulmonar de los pacientes con EPOC moderada a grave para poder mejorar su manejo&#46; El objetivo de este estudio fue determinar si la presencia de HTP en la EPOC se asociaba con una disminuci&#243;n en la tolerancia al ejercicio en una cohorte de pacientes con EPOC estable&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">M&#233;todos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Estudio transversal de 174 pacientes con EPOC cl&#237;nicamente estables&#58; 109 de ellos no mostraban HTP y 65 de ellos s&#237; &#40;EPOC-HTP&#41;&#46; Valoramos la informaci&#243;n sociodemogr&#225;fica&#44; la funci&#243;n pulmonar&#44; la calidad de vida&#44; la disnea&#44; realizamos una prueba de ejercicio cardiopulmonar &#40;PECP&#41;&#44; medimos el tiempo de tolerancia de ejercicio constante y realizamos de marcha de seis minutos &#40;6MWT&#44; por sus siglas en ingl&#233;s&#41;&#46; Elaboramos un modelo de regresi&#243;n log&#237;stica para explorar el impacto de la HTP en la capacidad de ejercicio de los pacientes con EPOC&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Resultados</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Los pacientes con EPOC-HTP mostraron una menor capacidad de ejercicio&#44; tanto en las pruebas m&#225;ximas &#40;PECP&#41; &#40;43<span class="elsevierStyleHsp" style=""></span>&#40;20&#41;<span class="elsevierStyleHsp" style=""></span>W frente a 68<span class="elsevierStyleHsp" style=""></span>&#40;27&#41;<span class="elsevierStyleHsp" style=""></span>W y 50<span class="elsevierStyleHsp" style=""></span>&#40;19&#41;&#37; frente a 71<span class="elsevierStyleHsp" style=""></span>&#40;18&#41;&#37; de consumo de ox&#237;geno m&#225;ximo predicho &#40;VO<span class="elsevierStyleInf">2</span>max&#41;&#44; para pacientes con EPOC-HTP y pacientes con EPOC&#44; respectivamente&#41; como en las pruebas subm&#225;ximas &#40;6MWT&#41; &#40;382<span class="elsevierStyleHsp" style=""></span>&#40;94&#41;<span class="elsevierStyleHsp" style=""></span>m frente a 486<span class="elsevierStyleHsp" style=""></span>&#40;95&#41;<span class="elsevierStyleHsp" style=""></span>m&#41;&#46; Adem&#225;s&#44; el grupo de EPOC-HTP present&#243; un menor tiempo de resistencia que el grupo de EPOC sin HTP &#40;265<span class="elsevierStyleHsp" style=""></span>&#40;113&#41;<span class="elsevierStyleHsp" style=""></span>s y 295<span class="elsevierStyleHsp" style=""></span>&#40;164&#41;<span class="elsevierStyleHsp" style=""></span>s&#44; respectivamente&#41;&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusiones</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">La presencia de HTP es un factor independiente que afecta a la capacidad de ejercicio en la EPOC&#46;</p></span>"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Definition of abbreviations&#58; BMI&#58; body mass index&#59; mMRC&#58; modified Medical Research Council scale&#59; SGRQ&#58; Sant George Respiratory Questionnaire&#59; FEV<span class="elsevierStyleInf">1</span>&#58; force expiratory volume in the first second&#59; &#37;pred&#58; &#37; of the predicted value&#59; FVC&#58; force vital capacity&#59; IC&#58; inspiratory capacity&#59; RV&#58; residual volume&#59; TLC&#58; total lung capacity&#59; DL<span class="elsevierStyleInf">CO</span>&#58; diffusion capacity of the lung for CO&#59; K<span class="elsevierStyleInf">CO</span>&#58; DL<span class="elsevierStyleInf">CO</span> corrected for alveolar volume&#59; PaO<span class="elsevierStyleInf">2</span>&#58; partial pressure of O<span class="elsevierStyleInf">2</span> in arterial blood&#59; PaCO<span class="elsevierStyleInf">2</span>&#58; partial pressure of CO<span class="elsevierStyleInf">2</span> in arterial blood&#59; sPAP&#58; systolic Pulmonary Arterial Pressure&#46; Values are expressed as mean &#40;SD&#41; when data is normally distributed or as median and interquartile range &#91;P25&#8211;P75&#93; when data distribution is skewed&#46;</p>"
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Current smoker&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Tobacco exposure&#44; pack-yrs</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">GOLD&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Impact&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " colspan="5" align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>FEV<span class="elsevierStyleInf">1</span>&#44; &#37; predicted&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>FVC&#44; &#37; predicted&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">66 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>FEV<span class="elsevierStyleInf">1</span>&#47;FVC&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">44&#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TLC&#44; &#37; predicted&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">102 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">116 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>RV&#44; &#37; predicted&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">153 &#91;138&#59; 180&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">192 &#91;159&#59; 237&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>IC&#44; &#37; predicted&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">67 &#91;58&#59; 85&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">59 &#91;48&#59; 66&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>DL<span class="elsevierStyleInf">CO</span>&#44; &#37; predicted&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>K<span class="elsevierStyleInf">CO</span>&#44; &#37; predicted&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>PaO<span class="elsevierStyleInf">2</span>&#44; mmHg&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#46;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>PaCO<span class="elsevierStyleInf">2</span>&#44; mmHg&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " colspan="5" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Echocardiogram</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>sPAP&#44; mmHg&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">46 &#91;41&#59; 50&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Definition of abbreviation&#58; CPET&#58; cardiopulmonary exercise test&#59; 6MWD&#58; six-minute walk distance&#59; VO<span class="elsevierStyleInf">2</span>&#58; oxygen consumption&#59; Wmax&#58; maximum work-load&#59; VCO<span class="elsevierStyleInf">2</span>&#58; carbon dioxide output&#59; VE&#58; minute ventilation&#59; MVV&#58; maximal voluntary ventilation&#59; HR&#58; heart rate&#59; SpO<span class="elsevierStyleInf">2</span>&#58; pulse oximetry oxygen saturation&#46;</p><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Values are expressed as mean &#40;SD&#41; when data is normally distributed or as median and interquartile range &#91;P25&#8211;P75&#93; when data distribution is skewed&#46;</p>"
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">COPD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">COPD-PH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Six minute walk test</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>6MWD&#44; m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">446 &#40;107&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">486 &#40;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">382 &#40;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Final SpO<span class="elsevierStyleInf">2</span>&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90 &#91;85&#59; 93&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92 &#91;88&#59; 94&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86 &#91;78&#59; 90&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Final Dyspnea&#44; Borg scale&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#91;2&#59; 5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#91;2&#59; 5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#91;3&#59; 6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Final Leg fatigue&#44; Borg scale&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#91;1&#59; 4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#91;1&#59; 4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#91;1&#59; 5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;080&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Cardiopulmonary exercise test</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Wmax&#44; watts&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57 &#40;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68 &#40;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Wmax&#44; &#37; predicted&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>VO<span class="elsevierStyleInf">2</span>peak&#44; mL&#47;min&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1016 &#40;369&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1185 &#40;350&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">795 &#40;261&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>VO<span class="elsevierStyleInf">2</span>peak&#44; &#37; predicted&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71 &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>VO<span class="elsevierStyleInf">2</span>peak&#44; mL&#47;min&#47;kg&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>VCO<span class="elsevierStyleInf">2</span>peak&#44; mL&#47;min&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1092 &#40;445&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1289 &#40;436&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">838 &#40;309&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>VEmax&#44; &#37; predicted&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">110 &#40;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">113 &#40;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">107 &#40;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;040&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>MVV&#44; L&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">45 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ventilatory reserve&#44; &#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5&#46;9 &#40;24&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;092&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Peak HR&#44; bpm&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">126 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">124 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;525&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Oxygen pulse mL&#47;beat&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;4 &#40;2&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;5 &#40;2&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Oxygen pulse&#44; &#37; predicted&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73 &#40;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Final SpO<span class="elsevierStyleInf">2</span>&#44; &#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">94 &#91;91&#59; 96&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">95 &#91;93&#59; 97&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">93 &#91;90&#59; 95&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Final Dyspnea&#44; Borg scale&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">5 &#91;4&#59; 6&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4 &#91;3&#59; 6&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7 &#91;4&#59; 8&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Final Leg fatigue&#44; Borg scale&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">5 &#91;4&#59; 6&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5 &#91;4&#59; 6&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;91 &#40;0&#46;91&#59; 4&#46;03&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;087&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;05 &#40;1&#46;01&#59; 1&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                        "paginaFinal" => "1320"
                        "link" => array:1 [
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                        "link" => array:1 [
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                        "link" => array:1 [
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                        "paginaFinal" => "980"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effect of pulmonary hypertension on aerobic exercise capacity in lung transplant candidates with advanced emphysema"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "Y&#46; Adir"
                            1 => "J&#46;E&#46; Ollech"
                            2 => "B&#46; Vainshelboim"
                            3 => "Y&#46; Shostak"
                            4 => "A&#46; Laor"
                            5 => "M&#46;R&#46; Kramer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00408-015-9698-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lung"
                        "fecha" => "2015"
                        "volumen" => "193"
                        "paginaInicial" => "223"
                        "paginaFinal" => "229"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25749664"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiopulmonary exercise test characteristics in patients with chronic obstructive pulmonary disease and associated pulmonary hypertension"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Holverda"
                            1 => "H&#46;J&#46; Bogaard"
                            2 => "H&#46; Groepenhoff"
                            3 => "P&#46;E&#46; Postmus"
                            4 => "A&#46; Boonstra"
                            5 => "A&#46; Vonk-Noordegraaf"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000110207"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respiration"
                        "fecha" => "2008"
                        "volumen" => "76"
                        "paginaInicial" => "160"
                        "paginaFinal" => "167"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17960052"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Aerobic exercise capacity in COPD patients with and without pulmonary hypertension"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Pynnaert"
                            1 => "M&#46; Lamotte"
                            2 => "R&#46; Naeije"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rmed.2009.06.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Med"
                        "fecha" => "2010"
                        "volumen" => "104"
                        "paginaInicial" => "121"
                        "paginaFinal" => "126"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19577458"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0275"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Abnormal pulmonary arterial pressure limits exercise capacity in patients with COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Vonbank"
                            1 => "G&#46;C&#46; Funk"
                            2 => "B&#46; Marzluf"
                            3 => "B&#46; Burian"
                            4 => "R&#46; Ziesche"
                            5 => "L&#46; Stiebellehner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00508-008-1103-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "Wien Klin Wochenschr"
                        "fecha" => "2008"
                        "volumen" => "120"
                        "paginaInicial" => "749"
                        "paginaFinal" => "755"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19122986"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0280"
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                0 => array:1 [
                  "referenciaCompleta" => "Nathan SD&#44; Barber&#224; JA&#44; Gaine SP&#44; Harari S&#44; Martinez FJ&#44; Olschewski H&#44; et al&#46; Pulmonary hypertension in chronic lung disease and hypoxia&#46; Eur Respir J&#46; 1914&#59;180&#58;53&#46; <a target="_blank" href="doi:10.1183/13993003.01914-2018">doi&#58;10&#46;1183&#47;13993003&#46;01914-2018</a>&#46;"
                ]
              ]
            ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ventilatory and cardiocirculatory exercise profiles in COPD&#58; the role of pulmonary hypertension"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46;G&#46; Boerrigter"
                            1 => "H&#46;J&#46; Bogaard"
                            2 => "P&#46; Trip"
                            3 => "H&#46; Groepenhoff"
                            4 => "H&#46; Rietema"
                            5 => "S&#46; Holverda"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.11-2798"
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                        "tituloSerie" => "Chest"
                        "fecha" => "2012"
                        "volumen" => "142"
                        "paginaInicial" => "1166"
                        "paginaFinal" => "1174"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22556320"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0290"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Strengthening the Reporting of Observational Studies in Epidemiology &#40;STROBE&#41; statement&#58; guidelines for reporting observational studies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46; Von Elm"
                            1 => "D&#46;G&#46; Altman"
                            2 => "M&#46; Egger"
                            3 => "S&#46;J&#46; Pocock"
                            4 => "P&#46;C&#46; G&#248;tzsche"
                            5 => "J&#46;P&#46; Vandenbroucke"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7326/0003-4819-147-8-200710160-00010"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "2007"
                        "volumen" => "147"
                        "paginaInicial" => "573"
                        "paginaFinal" => "577"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17938396"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0295"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2015 ESC&#47;ERS guidelines for the diagnosis and treatment of pulmonary hypertension&#58; the joint task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology &#40;ESC&#41; and the European Respiratory Society &#40;ERS&#41;&#58; endorsed by&#58; Association for European Paediatric and Congenital Cardiology &#40;AEPC&#41; International Society for Heart and Lung Transplantation &#40;ISHLT&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; Gali&#232;"
                            1 => "M&#46; Humbert"
                            2 => "J&#46;L&#46; Vachiery"
                            3 => "S&#46; Gibbs"
                            4 => "I&#46; Lang"
                            5 => "A&#46; Torbicki"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehv317"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2016"
                        "volumen" => "37"
                        "paginaInicial" => "67"
                        "paginaFinal" => "119"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26320113"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0300"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recommendations for chamber quantification&#58; a report from the American Society of Echocardiography&#39;s Guidelines and Standards Committee and the Chamber Quantification Writing Group&#44; developed in conjunction with the European Association of Echocardiography&#44; a branch of the European Society of Cardiology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;M&#46; Lang"
                            1 => "M&#46; Bierig"
                            2 => "R&#46;B&#46; Devereux"
                            3 => "F&#46;A&#46; Flachskampf"
                            4 => "E&#46; Foster"
                            5 => "P&#46;A&#46; Pellikka"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.echo.2005.10.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Soc Echocardiogr"
                        "fecha" => "2005"
                        "volumen" => "18"
                        "paginaInicial" => "1440"
                        "paginaFinal" => "1463"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16376782"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0305"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines for the echocardiographic assessment of the right heart in adults&#58; a report from the American Society of Echocardiography&#58; endorsed by the European Association of Echocardiography&#44; a registered branch of the European Society of Cardiology&#44; and the Canadian Society of Echocardiography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46;G&#46; Rudski"
                            1 => "W&#46;W&#46; Lai"
                            2 => "J&#46; Afilalo"
                            3 => "L&#46; Hua"
                            4 => "M&#46;D&#46; Handschumacher"
                            5 => "K&#46; Chandrasekaran"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.echo.2010.05.010"
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                        "tituloSerie" => "J Am Soc Echocardiogr"
                        "fecha" => "2010"
                        "volumen" => "23"
                        "paginaInicial" => "685"
                        "paginaFinal" => "713"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20620859"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Validity and reliability of the St George&#39;s Respiratory Questionnaire after adaptation to a different language and culture&#58; the Spanish example"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Ferrer"
                            1 => "J&#46; Alonso"
                            2 => "L&#46; Prieto"
                            3 => "V&#46; Plaza"
                            4 => "E&#46; Mons&#243;"
                            5 => "R&#46; Marrades"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/09031936.96.09061160"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "1996"
                        "volumen" => "9"
                        "paginaInicial" => "1160"
                        "paginaFinal" => "1166"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8804932"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of clinical methods for rating dyspnea"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46;A&#46; Mahler"
                            1 => "C&#46;K&#46; Wells"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.93.3.580"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1988"
                        "volumen" => "93"
                        "paginaInicial" => "580"
                        "paginaFinal" => "586"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3342669"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "ATS&#47;ACCP statement on cardiopulmonary exercise testing"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "American Thoracic Society&#44; and American College of Chest Physicians"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.167.2.211"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2003"
                        "volumen" => "167"
                        "paginaInicial" => "211"
                        "paginaFinal" => "277"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12524257"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recommendations on the use of exercise testing in clinical practice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Palange"
                            1 => "S&#46; Ward"
                            2 => "K&#46; Carlsen"
                            3 => "R&#46; Casaburi"
                            4 => "C&#46; Gallagher"
                            5 => "R&#46; Gosselink"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2007"
                        "volumen" => "29"
                        "paginaInicial" => "185"
                        "paginaFinal" => "209"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An official European Respiratory Society&#47;American Thoracic Society technical standard&#58; field walking tests in chronic respiratory disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;E&#46; Holland"
                            1 => "M&#46;A&#46; Spruit"
                            2 => "T&#46; Troosters"
                            3 => "M&#46;A&#46; Puhan"
                            4 => "V&#46; Pepin"
                            5 => "D&#46; Saey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/09031936.00150314"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2014"
                        "volumen" => "44"
                        "paginaInicial" => "1428"
                        "paginaFinal" => "1446"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25359355"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "27"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sildenafil to improve respiratory rehabilitation outcomes in COPD&#58; a controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46; Blanco"
                            1 => "S&#46; Santos"
                            2 => "J&#46; Gea"
                            3 => "R&#46; G&#252;ell"
                            4 => "F&#46; Torres"
                            5 => "E&#46; Gimeno-Santos"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1183/09031936.00176312"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2013"
                        "volumen" => "42"
                        "paginaInicial" => "982"
                        "paginaFinal" => "992"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23429918"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiopulmonary exercise testing&#58; what is its value&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Guazzi"
                            1 => "F&#46; Bandera"
                            2 => "C&#46; Ozemek"
                            3 => "D&#46; Systrom"
                            4 => "R&#46; Arena"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2017.08.012"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2017"
                        "volumen" => "70"
                        "paginaInicial" => "1618"
                        "paginaFinal" => "1636"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28935040"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0345"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Exercise capacity&#44; ventilatory&#44; circulatory&#44; and symptom limitation in patients with chronic airflow limitation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
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                            1 => "P&#46; Leblanc"
                            2 => "D&#46;H&#46; Martin"
                            3 => "E&#46; Summers"
                            4 => "N&#46;L&#46; Jones"
                            5 => "E&#46; Campbell"
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                        ]
                      ]
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                    0 => array:2 [
                      "doi" => "10.1164/ajrccm/146.4.935"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Rev Respir Dis"
                        "fecha" => "1992"
                        "volumen" => "146"
                        "paginaInicial" => "935"
                        "paginaFinal" => "940"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1416421"
                            "web" => "Medline"
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                ]
              ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Hyperinflation&#44; dyspnea&#44; and exercise intolerance in chronic obstructive pulmonary disease"
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                          "etal" => false
                          "autores" => array:1 [
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1513/pats.200508-093DO"
                      "Revista" => array:6 [
                        "tituloSerie" => "Proc Am Thorac Soc"
                        "fecha" => "2006"
                        "volumen" => "3"
                        "paginaInicial" => "180"
                        "paginaFinal" => "184"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16565429"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0355"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Peripheral skeletal muscles and exercise performance in patients with chronic obstructive pulmonary disease"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46; Gosselink"
                            1 => "M&#46; Decramer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Monaldi Arch Chest Dis"
                        "fecha" => "1998"
                        "volumen" => "53"
                        "paginaInicial" => "419"
                        "paginaFinal" => "423"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9828598"
                            "web" => "Medline"
                          ]
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                      ]
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                  ]
                ]
              ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "The relationship between the right ventricle and its load in pulmonary hypertension"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;V&#46; Noordegraaf"
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                            2 => "N&#46; Westerhof"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2016.10.047"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2017"
                        "volumen" => "69"
                        "paginaInicial" => "236"
                        "paginaFinal" => "243"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28081831"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "The role of cardiopulmonary exercise tests in pulmonary arterial hypertension"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Farina"
                            1 => "M&#46; Correale"
                            2 => "N&#46; Bruno"
                            3 => "S&#46; Paolillo"
                            4 => "E&#46; Salvioni"
                            5 => "R&#46; Badagliacca"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/16000617.0134-2017"
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Respir Rev"
                        "fecha" => "2018"
                        "volumen" => "27"
                        "paginaInicial" => "170134"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29720508"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0370"
              "etiqueta" => "34"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Principles of exercise testing and interpretation&#58; including pathophysiology and clinical applications"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "K&#46; Wasserman"
                            1 => "J&#46;E&#46; Hansen"
                            2 => "D&#46;Y&#46; Sue"
                            3 => "W&#46;W&#46; Stringer"
                            4 => "B&#46;J&#46; Whipp"
                          ]
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                      ]
                    ]
                  ]
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                    0 => array:1 [
                      "Libro" => array:4 [
                        "edicion" => "4th ed&#46;"
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                        "editorialLocalizacion" => "Philadelphia&#44; PA"
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                    ]
                  ]
                ]
              ]
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              "etiqueta" => "35"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Cardiopulmonary exercise test and PaO<span class="elsevierStyleInf">2</span> in evaluation of pulmonary hypertension in COPD"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "I&#46; Skj&#248;rten"
                            1 => "J&#46;M&#46; Hilde"
                            2 => "M&#46;N&#46; Melsom"
                            3 => "J&#46; Hisdal"
                            4 => "V&#46; Hansteen"
                            5 => "K&#46; Steine"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Chron Obstruc Pulmon Dis"
                        "fecha" => "2017"
                        "volumen" => "13"
                        "paginaInicial" => "91"
                        "paginaFinal" => "100"
                      ]
                    ]
                  ]
                ]
              ]
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            35 => array:3 [
              "identificador" => "bib0380"
              "etiqueta" => "36"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "The body-mass index&#44; airflow obstruction&#44; dyspnea&#44; and exercise capacity index in chronic obstructive pulmonary disease"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46;R&#46; Celli"
                            1 => "C&#46;G&#46; Cote"
                            2 => "J&#46;M&#46; Marin"
                            3 => "C&#46; Casanova"
                            4 => "M&#46; Montes de Oca"
                            5 => "R&#46;A&#46; Mendez"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa021322"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2004"
                        "volumen" => "350"
                        "paginaInicial" => "1005"
                        "paginaFinal" => "1012"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14999112"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "referencia" => array:1 [
                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "ERS statement on exercise training and rehabilitation in patients with severe chronic pulmonary hypertension"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Gr&#252;nig"
                            1 => "C&#46; Eichstaedt"
                            2 => "J&#46;A&#46; Barber&#224;"
                            3 => "N&#46; Benjamin"
                            4 => "I&#46; Blanco"
                            5 => "E&#46; Bossone"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/13993003.00332-2018"
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2019"
                        "volumen" => "53"
                        "paginaInicial" => "1800332"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30578391"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Therapy for pulmonary arterial hypertension in adults&#58; update of the CHEST guideline and expert panel report"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;R&#46; Klinger"
                            1 => "C&#46;G&#46; Elliott"
                            2 => "D&#46;J&#46; Levine"
                            3 => "E&#46; Bossone"
                            4 => "L&#46; Duvall"
                            5 => "K&#46; Fagan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.chest.2018.11.030"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2019"
                        "volumen" => "155"
                        "paginaInicial" => "565"
                        "paginaFinal" => "586"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30660783"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "39"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Diagnostic accuracy of echocardiography for pulmonary hypertension&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Janda"
                            1 => "N&#46; Shahidi"
                            2 => "K&#46; Gin"
                            3 => "J&#46; Swiston"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/hrt.2010.212084"
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                        "tituloSerie" => "Heart"
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                        "volumen" => "97"
                        "paginaInicial" => "612"
                        "paginaFinal" => "622"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21357375"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Validation study on the accuracy of echocardiographic measurements of right ventricular systolic function in pulmonary hypertension"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Sato"
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                            2 => "H&#46; Ohira"
                            3 => "N&#46; Oyama-Manabe"
                            4 => "A&#46; Yamada"
                            5 => "Y&#46;M&#46; Ito"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.echo.2011.12.012"
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                        "tituloSerie" => "J Am Soc Echocardiogr"
                        "fecha" => "2012"
                        "volumen" => "25"
                        "paginaInicial" => "280"
                        "paginaFinal" => "286"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22230250"
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                          ]
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                      ]
                    ]
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                ]
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