We found that NT-proBNP level of ≥ 650 pg/mL, echocardiographic sPAP of ≥ 56 mm Hg, and PA to Ao diameter ratio of ≥ 0.93 on chest CT scan are instrumental to diagnose severe PH in patients with COPD. This evidence concerns the gene NPPB and chronic obstructive pulmonary disease.