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Unrecognised ventricular dysfunction in COPD

A Macchia1, J J Rodriguez Moncalvo, M Kleinert

  • 1Epidemiology Section, Dept of Internal Medicine, CEMIC (Centro de Educación Médica e Investigaciones Clínicas), Buenos Aires, Argentina. macchia@negrisud.it

The European Respiratory Journal
|June 25, 2011
PubMed

Insights

Chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF) often coexist. Ventricular dysfunction in COPD patients significantly increases mortality risk, suggesting routine cardiac screening for these individuals.

Area of Science:

  • Cardiology
  • Pulmonology
  • Internal Medicine

Background:

  • Chronic congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD) are prevalent conditions with shared risk factors, yet often studied in isolation.
  • The coexistence of these diseases can complicate patient management and prognosis.
  • Understanding the interplay between cardiac and pulmonary dysfunction is crucial for improving patient outcomes.

Purpose of the Study:

  • To determine the prevalence of left ventricular dysfunction in patients with COPD.
  • To assess the prevalence of airway obstruction in patients with CHF.
  • To evaluate the prognostic impact of these coexisting conditions on patient survival.

Main Methods:

  • A prospective cohort study involving 201 stable CHF patients (≥60 years) and 218 stable COPD patients (≥60 years).
  • CHF patients underwent spirometry; COPD patients underwent echocardiography and B-type natriuretic peptide (BNP) measurement.
  • Patients were followed for 2 years to assess mortality and survival rates.

Main Results:

  • Airway obstruction was present in 37.3% of CHF patients.
  • Ventricular dysfunction was identified in 17% of COPD patients.
  • Ventricular dysfunction in COPD patients was associated with a trend towards increased mortality (HR 2.34, p=0.053), while airway obstruction in CHF patients did not affect survival.

Conclusions:

  • CHF and COPD frequently coexist in older adults.
  • Ventricular dysfunction is a significant predictor of worsened survival in COPD patients.
  • Routine cardiac assessment (BNP or echocardiogram) is recommended for COPD patients due to the high prevalence and prognostic implications of ventricular dysfunction.

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