Long-term prognosis of polyvascular patients with associated chronic obstructive pulmonary disease

To evaluate by various tools the prognosis of the polyvascular patients (defined as the presence of more than one affected vascular bed), who also associate chronic obstructive pulmonary disease.

Fifty-eight patients discharged after an episode of acute cardiorespiratory failure were examined at 3 month-intervals for 1, 2 and 3 years (2010-2012). The following were performed: physical examination, biochemical and hematological tests, spirometry, electrocardiography, transthoracic echocardiography, brain computer tomography or magnetic resonance imaging. All patients in our study were smokers with chronic pulmonary obstructive disease. Treatment relied on the European recommendations for cardiac pathology and associated medical conditions.

A favorable clinical course was noticed in compliant patients. Patients with metabolic syndrome and/or old stroke, and peripheral arterial disease have a poor prognosis. A strong link seems to exist between systolic function of the right ventricle and cardiovascular mortality. The association of this condition to ischemic heart disease modifies the right ventricle hemodynamics.

Polyvascular patients in acute cardiorespiratory failure have a mortality of 36% in the first 3 weeks. After 3 years, 86% of the patients survive. The modern methods of diagnosis and treatment allow improving the quality of life and increasing its duration.