title: The association between COPD and heart failure risk: a review.
abstract: Chronic obstructive pulmonary disease (COPD) is commonly associated with heart failure (HF) in clinical practice since they share the same pathogenic mechanism. Both conditions incur significant morbidity and mortality. Therefore, the prognosis of COPD and HF combined is poorer than for either disease alone. Nevertheless, usually only one of them is diagnosed. An active search for each condition using clinical examination and additional tests including plasma natriuretic peptides, lung function testing, and echocardiography should be obtained. The combination of COPD and HF presents many therapeutic challenges. The beneficial effects of selective β1-blockers should not be denied in stable patients who have HF and coexisting COPD. Additionally, statins, angiotensin-converting enzyme inhibitors, and angiotensin-receptor blockers may reduce the morbidity and mortality of COPD patients. Moreover, caution is advised with use of inhaled β2-agonists for the treatment of COPD in patients with HF. Finally, noninvasive ventilation, added to conventional therapy, improves the outcome of patients with acute respiratory failure due to hypercapnic exacerbation of COPD or HF in situations of acute pulmonary edema. The establishment of a combined and integrated approach to managing these comorbidities would seem an appropriate strategy. Additional studies providing new data on the pathogenesis and management of patients with COPD and HF are needed, with the purpose of trying to improve quality of life as well as survival of these patients.
authors.affiliation: Pulmonology Department, Gregorio Maranon University Hospital, Complutense University of Madrid, Madrid, Spain. jmiguel.hgugm@salud.madrid.org
authors.forename: Javier
authors.initials: J
authors.lastname: de Miguel Díez
authors.forename: Jorge
authors.initials: J
authors.lastname: Chancafe Morgan
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Jiménez García
mesh_terms: D058671:Adrenergic beta-1 Receptor Antagonists / Q000627:therapeutic use; D058666:Adrenergic beta-2 Receptor Agonists; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D015897:Comorbidity; D000075202:Contraindications; D019468:Disease Management; D004452:Echocardiography; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D045265:Natriuretic Peptides / Q000097:blood; D063087:Noninvasive Ventilation / Q000379:methods*; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D012129:Respiratory Function Tests
chemical_list: D058671:Adrenergic beta-1 Receptor Antagonists; D058666:Adrenergic beta-2 Receptor Agonists; D002317:Cardiovascular Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D045265:Natriuretic Peptides
keywords: chronic obstructive pulmonary disease; heart failure