Chronic obstructive pulmonary disease in patients admitted with heart failure.
OBJECTIVE
Chronic obstructive pulmonary disease (COPD) is an important differential diagnosis in patients with heart failure (HF). The primary aims were to determine the prevalence of COPD and to test the accuracy of self-reported COPD in patients admitted with HF. Secondary aims were to study a possible relationship between right and left ventricular function and pulmonary function.


METHODS
Prospective substudy.


METHODS
Systematic screening at 11 centres.


METHODS
Consecutive patients (n = 532) admitted with HF requiring medical treatment with diuretics and an episode with symptoms corresponding to New York Heart Association class III-IV within a month prior to admission.


METHODS
Forced expiratory volume in 1 s (FEV(1)) and forced vital capacity (FVC) were measured by spirometry and ventricular function by echocardiography. The diagnosis of COPD and HF were made according to established criteria.


RESULTS
The prevalence of COPD was 35%. Only 43% of the patients with COPD had self-reported COPD and one-third of patients with self-reported COPD did not have COPD based on spirometry. The prevalence of COPD in patients with preserved left ventricular ejection fraction (i.e. LVEF >or=45%) was significantly higher than in patients with impaired LVEF (41% vs. 31%, P = 0.03). FEV(1) and FVC were negatively correlated with right ventricular end-diastolic diameter and tricuspid annular plane systolic excursion and FVC positively correlated with systolic gradient across the tricuspid valve.


CONCLUSIONS
Chronic obstructive pulmonary disease is frequent in patients admitted with HF and self-reported COPD only identifies a minority. The prevalence of COPD was high in both patients with systolic and nonsystolic HF.
Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
K K
KK
Iversen
J
J
Kjaergaard
D
D
Akkan
L
L
Kober
C
C
Torp-Pedersen
C
C
Hassager
J
J
Vestbo
E
E
Kjoller
D000368:Aged; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D012129:Respiratory Function Tests; D012680:Sensitivity and Specificity; D013147:Spirometry