title: Prognostic implications of heart failure with preserved ejection fraction in patients with an exacerbation of chronic obstructive pulmonary disease.
abstract: Diagnosing heart failure with preserved ejection fraction (HFpEF) in patients with chronic obstructive pulmonary disease (COPD) is difficult due to overlapping pathophysiological pathways, risk factors and clinical presentations. We investigated the prevalence and prognostic implications of coexisting HFpEF in patients hospitalized for acute exacerbation of COPD. A total of 116 consecutive patients with an acute exacerbation of COPD were evaluated for HFpEF and followed for an average period of 22 ± 9 months for the occurrence of death from any cause. HFpEF was diagnosed in 22 (19 %) patients with COPD, who were older, and also had higher LV mass, left atrial size, and mitral E/Ea ratio than those without HFpEF (p < 0.05 for all comparisons). HFpEF was not independently associated with all-cause mortality [hazard ratio (HR) 1.07, 95 % confidence interval (CI) 0.44-2.62]. Global initiative for chronic Obstructive Lung Disease (GOLD) stage (IV vs. I-III, HR 2.37, CI 1.23-4.59) and N-terminal pro B-type natriuretic peptide (NT-proBNP) levels (HR 2.79, CI 1.12-6.98) were independent predictors of long-term survival. HFpEF is present in one-fifth of patients with exacerbated COPD. Non-invasively diagnosed HFpEF may not be an independent predictor of all-cause mortality. Elevated NT-proBNP levels and very severe COPD were independently associated with unfavorable overall survival.
authors.affiliation: University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia.
authors.forename: Robert
authors.initials: R
authors.lastname: Marcun
authors.affiliation: Department of Cardiology, Faculty of Medicine, Clinical Hospital Center Zemun, University of Belgrade, Belgrade, Serbia. future.ivan@gmail.com.
authors.forename: Ivan
authors.initials: I
authors.lastname: Stankovic
authors.affiliation: Department of Cardiology, Faculty of Medicine, Clinical Hospital Center Zemun, University of Belgrade, Belgrade, Serbia.
authors.forename: Radosav
authors.initials: R
authors.lastname: Vidakovic
authors.affiliation: Chair of Public Health, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
authors.forename: Jerneja
authors.initials: J
authors.lastname: Farkas
authors.affiliation: University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia.
authors.forename: Sasa
authors.initials: S
authors.lastname: Kadivec
authors.affiliation: Department of Cardiology, Faculty of Medicine, Clinical Hospital Center Zemun, University of Belgrade, Belgrade, Serbia.
authors.forename: Biljana
authors.initials: B
authors.lastname: Putnikovic
authors.affiliation: Department of Cardiology, Faculty of Medicine, Clinical Hospital Center Zemun, University of Belgrade, Belgrade, Serbia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Ilic
authors.affiliation: Department of Cardiology, Faculty of Medicine, Clinical Hospital Center Zemun, University of Belgrade, Belgrade, Serbia.
authors.forename: Aleksandar N
authors.initials: AN
authors.lastname: Neskovic
authors.affiliation: Department of Cardiology, General Hospital Celje, Oblakova cesta 5, 3000, Celje, Slovenia.|Chair of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
authors.forename: Mitja
authors.initials: M
authors.lastname: Lainscak
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D006760:Hospitalization; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000401:mortality / Q000503:physiopathology*; D012129:Respiratory Function Tests; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology; D015996:Survival Rate
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Chronic obstructive pulmonary disease; Heart failure with preserved ejection fraction; Outcome; Prevalence