What is your approach to pulmonary vasodilator therapy in patients with COPD and Severe Group 3 Pulmonary Hypertension?

I'd like to first acknowledge that there are no large randomized controlled trials specifically in patients with severe COPD-PH to guide practice. Before I consider PH-specific treatment, I like to exclude other causes of PH namely CTEPH, LHD, and CTD-PH which would influence treatment options. Seco...