{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T16:18:08Z","timestamp":1786465088740,"version":"build-2736575974"},"reference-count":34,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Adv. Respir. Med.","ARM"],"abstract":"<jats:p>Purpose: Pulmonary hypertension (PH) is a serious complication of COPD associated with worse outcomes. Reliable circulating biomarkers of pulmonary vascular involvement are lacking. Angiopoietin-1 (ANGP-1) and angiopoietin-2 (ANGP-2) regulate endothelial homeostasis, but their relationship with echocardiographically estimated pulmonary pressure in COPD remains uncertain. Methods: This prospective cross-sectional study included 70 consecutively recruited adults with COPD, stratified using a study-specific echocardiographic threshold into the COPD PH group (mPAP &gt; 20 mmHg; n = 46) and the COPD without PH (mPAP &lt; 20 mmHg; n = 24), together with 20 additional controls. This non-invasive stratification was not considered equivalent to PH confirmed by right heart catheterization. Serum ANGP-1 and ANGP-2 were measured using ELISA. Group differences and associations with e-mPAP and right atrial pressure (RAP) were assessed. Results: Median ANGP-1 was higher in the elevated e-mPAP group [8780.06 (IQR 7955.29\u20139902.88) pg\/mL] than in the lower e-mPAP group [3065.14 (1170.69\u20136200.41)] and controls [2997.19 (1292.13\u20133278.18); p &lt; 0.001]. ANGP-2 showed a similar pattern [6152.92 (5380.27\u20138652.50), 2669.77 (1802.18\u20134744.00), and 2405.54 (1779.73\u20133751.76) pg\/mL; p &lt; 0.001]. Among COPD participants, ANGP-1 and ANGP-2 correlated with e-mPAP (r = 0.64 and r = 0.54) and RAP (r = 0.54 and r = 0.52; all Holm-adjusted p &lt; 0.001). In multivariable models, e-mPAP and RAP were independently associated with ANGP-1, whereas RAP was independently associated with ANGP-2. Conclusions: Higher circulating ANGP-1 and ANGP-2 were associated with an elevated echo-estimated pulmonary-pressure phenotype in COPD. These findings are exploratory and require validation in larger cohorts using direct hemodynamic assessment.<\/jats:p>","DOI":"10.3390\/arm94040059","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T13:46:16Z","timestamp":1786455976000},"page":"59","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Serum Angiopoietin-1 and Angiopoietin-2 as Biomarkers of Pulmonary Hemodynamic Burden in COPD-Associated Pulmonary Hypertension: A Cross-Sectional Study"],"prefix":"10.3390","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6337-856X","authenticated-orcid":false,"given":"Jyoti","family":"Bajpai","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, KGMU, U.P., Lucknow 226003, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2360-7580","authenticated-orcid":false,"given":"Akshyaya","family":"Pradhan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, KGMU, U.P., Lucknow 226003, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Kaleem","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, KGMU, U.P., Lucknow 226003, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7520-5404","authenticated-orcid":false,"given":"Surya","family":"Kant","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, KGMU, U.P., Lucknow 226003, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2973-1793","authenticated-orcid":false,"given":"Ajay Kumar","family":"Verma","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, RML Institute of Medical Sciences, Lucknow 226010, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darshan Kumar","family":"Bajaj","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, KGMU, U.P., Lucknow 226003, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishi","family":"Sethi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, KGMU, U.P., Lucknow 226003, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4895-9707","authenticated-orcid":false,"given":"Mario","family":"Cazzola","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina dei Sistemi, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"ref_1","unstructured":"Global Initiative for Chronic Obstructive Lung Disease (2026, April 25). 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