Objective:To explore the role of cardiopulmonary exercise testing(CPET)in noninvasive evaluation of chronic obstructive pulmonary disease(COPD)related pulmonary hypertension(PH)by comparing the differences of gas exchange and exercise tolerance in CPET between patients with COPD related PH and patients without PH. Method:A total of 94 stable COPD patients were divided into COPD-nonPH group,COPD-PH group,COPD-severe PH group according to mean pulmonary artery pressure measured by right heart catheterization. All patients underwent routine lung function testing and CPET. Result:Compared with COPD-nonPH,diffusing lung capacity for carbon monoxide(DLCO)decreased significantly after PH occurred[(46.5 ± 21.8)% vs.(64.6 ± 34.0)%,P < 0.05]. Peak load,peak VO2% pred,peak VO2/kg,peak O2 pulse,and oxygen uptake efficiency slop(OUES)in COPD-PH group were lower than those in COPD-nonPH group,and further decreased with PH severity,there were statistically significant differences(P < 0.05). The ventilatory equivalents for CO2 nadir(VE/VCO2 nadir)in COPD-PH group was higher than that in COPD-nonPH group,and increased significantly in severe PH group(49.0 ± 24.6 vs. 38.6 ± 11.4 vs. 35.6 ± 9.6,P < 0.05). Other outcomes such as peak heart rate,respiratory exchange rate(RER),oxygen uptake efficiency platform(OUEP),and peak end-tidal CO2 partial pressure(PetCO2) showed no significant differences among the three groups(P > 0.05). Conclusion:Compared with COPD-nonPH patients,gas exchange and exercise tolerance significantly decreased in COPD-PH patients,and further deteriorated with the severity of PH. CPET could be used as an effective tool for noninvasive evaluation of COPD related PH.