Obstructive Ventilatory Disorder in Heart Failure-Caused by the Heart or the Lung?
Heart failure (HF) is a clinical syndrome frequently associated with airway obstruction, either as a respiratory comorbidity or as a direct consequence of HF pathophysiology. Recognizing the relative contribution of an underlying airway disease as opposed to airway obstruction due to volume overload and left atrial pressure elevation is of importance for the appropriate management of patients affected by HF. This review focuses on "les liaisons dangereuses" between the heart and the lungs, outlying recent advances linking in a vicious circle of chronic obstructive lung disease (COPD) and obstructive sleep apnea (OSA) on one side and HF on the other side. It also discusses the role of pivotal diagnostic tools such as pulmonary function tests and cardiopulmonary exercise test to determine the contribution of HF and COPD to symptoms and clinical status. Treatment implications are discussed as well.
Department of Cardiovascular, Neural and Metabolic Sciences, S. Luca Hospital, Istituto Auxologico Italiano, IRCCS, Milan, Italy.|Pulmonary Hypertension and Heart Failure Clinic, Department of Cardiology, Cliniques Universitaires de Bruxelles, Hôpital Académique Erasme, Brussels, Belgium.
Sergio
S
Caravita
Pulmonary Hypertension and Heart Failure Clinic, Department of Cardiology, Cliniques Universitaires de Bruxelles, Hôpital Académique Erasme, Brussels, Belgium. jeanluc.vachiery@erasme.ulb.ac.be.|Department of Cardiology, CUB Hôpital Erasme, 808 Route de Lennik, 1070, Brussels, Belgium. jeanluc.vachiery@erasme.ulb.ac.be.
Jean-Luc
JL
Vachiéry
D015897:Comorbidity; D005080:Exercise Test; D006333:Heart Failure / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000209:etiology*
Cardiopulmonary exercise test; Heart failure; Obstructive lung disease; Obstructive sleep apnea; Pulmonary function test; Pulmonary hypertension