title: Targeting occult heart failure in intensive care unit patients with acute chronic obstructive pulmonary disease exacerbation: effect on outcome and quality of life.
abstract: OBJECTIVE
  To estimate the prevalence of previously undiagnosed heart failure in mechanically ventilated patients with severe exacerbation of chronic obstructive pulmonary disease (COPD) and to evaluate the impact of specific heart failure treatment on patients' outcome.
  
  
  METHODS
  In this prospective study, we included 107 consecutive patients with COPD without known history of cardiac disease who were admitted to the intensive care unit (ICU) because of hypercapnic respiratory failure leading to mechanical ventilation.
  
  
  RESULTS
  Patients were divided into 4 groups according to the echocardiographic findings: patients with isolated right or left ventricular failure, biventricular failure, and normal heart function. Three of 4 patients demonstrated findings of heart failure. In 41%, the presence of previously unrecognized left ventricular dysfunction was revealed. Patients with isolated left ventricular dysfunction experienced less days on mechanical ventilation, less intensive care unit days, improved quality of life, and decreased in-hospital and 6-month mortality compared with patients with normal heart.
  
  
  CONCLUSIONS
  In mechanically ventilated patients with severe exacerbation of COPD, unrecognized left or right ventricular failure is common. Among patients with isolated left ventricular failure, the early detection and appropriate treatment improves long-term quality of life and may decrease the short- and 6-month morbidity and mortality.
authors.affiliation: Intensive Care Unit, Papageorgiou General Hospital, Thessaloniki, Greece. Electronic address: dmatamis@gmail.com.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Matamis
authors.affiliation: Intensive Care Unit, Papageorgiou General Hospital, Thessaloniki, Greece. Electronic address: dmatamis@gmail.com.
authors.forename: Mathew
authors.initials: M
authors.lastname: Tsagourias
authors.affiliation: Intensive Care Unit, University Hospital of Ioannina, Ioannina, Greece. Electronic address: thanasis.papathanasiou@gmail.com.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Papathanasiou
authors.affiliation: Intensive Care Unit, Papageorgiou General Hospital, Thessaloniki, Greece. Electronic address: thanasis.papathanasiou@gmail.com.
authors.forename: Helen
authors.initials: H
authors.lastname: Sineffaki
authors.affiliation: Intensive Care Unit, University Hospital of Ioannina, Ioannina, Greece. Electronic address: demylepida@yahoo.gr.
authors.forename: Dimitra
authors.initials: D
authors.lastname: Lepida
authors.affiliation: Intensive Care Unit, University Hospital of Ioannina, Ioannina, Greece. Electronic address: efiegaliatsou@gmail.com.
authors.forename: Eytychia
authors.initials: E
authors.lastname: Galiatsou
authors.affiliation: Intensive Care Unit, University Hospital of Ioannina, Ioannina, Greece. Electronic address: gnakos@cc.uoi.gr.
authors.forename: George
authors.initials: G
authors.lastname: Nakos
mesh_terms: D000368:Aged; D018450:Disease Progression; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000628:therapy*; D011788:Quality of Life; D012121:Respiration, Artificial / Q000009:adverse effects; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis
keywords: Chronic obstructive pulmonary disease; Echocardiogaphic examination; Heart failure; Mechanical ventilation