title: Unrecognised ventricular dysfunction in COPD.
abstract: While both chronic congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD) impose a substantial disease burden and share aetiological and epidemiological associations, they have largely been studied separately. The aim of our study was to assess the prevalence and the prognostic implications of the coexistence of left ventricular dysfunction in COPD patients and airway obstruction in CHF patients. We used a prospective cohort study including stable ≥ 60-yr-old patients with echocardiographically confirmed CHF (n=201) and stable ≥ 60-yr-old patients with clinically and spirometry-confirmed COPD (n=218). All CHF patients underwent routine spirometry, and all COPD patients underwent routine echocardiographic assessment and B-type natriuretic peptide (BNP) measurement. Patients were followed for 2 yrs. The prevalence of airway obstruction among CHF patients was 37.3% and the prevalence of ventricular dysfunction among COPD patients was 17%. The presence of ventricular dysfunction in patients with COPD tended to increase the risk of mortality during follow-up (hazard ratio 2.34, 95% CI 0.99-5.54; p=0.053). The presence of airway obstruction in patients with CHF did not influence survival. CHF and COPD frequently coexist, and ventricular dysfunction worsens survival in patients with COPD. Considering the high prevalence and the prognostic implications of ventricular dysfunction, routine assessment with either BNP or echocardiogram should be considered in COPD patients.
authors.affiliation: Epidemiology Section, Dept of Internal Medicine, CEMIC (Centro de Educación Médica e Investigaciones Clínicas), Buenos Aires, Argentina. macchia@negrisud.it
authors.forename: A
authors.initials: A
authors.lastname: Macchia
authors.forename: J J
authors.initials: JJ
authors.lastname: Rodriguez Moncalvo
authors.forename: M
authors.initials: M
authors.lastname: Kleinert
authors.forename: P D
authors.initials: PD
authors.lastname: Comignani
authors.forename: G
authors.initials: G
authors.lastname: Gimeno
authors.forename: D
authors.initials: D
authors.lastname: Arakaki
authors.forename: N
authors.initials: N
authors.lastname: Laffaye
authors.forename: J J
authors.initials: JJ
authors.lastname: Fuselli
authors.forename: H P
authors.initials: HP
authors.lastname: Massolin
authors.forename: J
authors.initials: J
authors.lastname: Gambarte
authors.forename: M
authors.initials: M
authors.lastname: Romero
authors.forename: G
authors.initials: G
authors.lastname: Tognoni
mesh_terms: D000368:Aged; D000402:Airway Obstruction; D001118:Argentina; D002309:Cardiology / Q000379:methods; D015331:Cohort Studies; D015897:Comorbidity; D004452:Echocardiography / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D015995:Prevalence; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000175:diagnosis*; D015272:Pulmonary Medicine / Q000379:methods; D012042:Registries; D013147:Spirometry / Q000379:methods; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000175:diagnosis*
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain