OBJECTIVE The present study was undertaken to assess the cardiopulmonary response during the initial period of exercise. METHODS Eight patients with COPD and 10 normal subjects were investigated during exercise (35W) in room air and oxygen breathing for 15 minutes, respectively. Pulmonary arterial mean pressure (mPAP), cardiac output (CO) and mixed venous oxygen saturation (SvO2) were measured by Swan-Ganz catheter during exercise. RESULTS Compared with normal controls, mPAP in COPD patients was increased and SvO2 decreased markedly both in room air and oxygen breathing during exercise. And CO increased relative slowly than that of normal controls. Furthermore, in patients with COPD, the time to reach their steady state in mPAP and SvO2 during exercise were delayed compared with normal controls. Moreover, we found that the time to reach their steady state in mPAP and SvO2 were shortened when the patients were given oxygen breathing during exercise. CONCLUSIONS The results indicate that the measurement of initial changes in mPAP and SvO2 during exercise have important clinical significance for evaluating the cardiopulmonary response in patients with COPD.