title: Prevalence of airflow obstruction in patients with stable systolic heart failure.
abstract: Chronic obstructive pulmonary disease (COPD) is an important differential diagnosis in heart failure (HF). However, routine use of spirometry in outpatient HF clinics is not implemented. The aim of the present study was to determine the prevalence of both airflow obstruction and non obstructive lung function impairment in patients with HF and to examine the effect of optimal medical treatment for HF on lung function parameters.
  
  
  
  Consecutive patients with HF (ejection fraction (EF) < 45%) and New York Heart Association (NYHA) functional class II-IV at 10 different outpatient heart failure clinics were examined with spirometry at their first visit and after optimal medical treatment for HF was achieved. airflow obstruction was classified and graded according to the GOLD 2011 revision.
  
  
  
  Baseline spirometry was performed in 593 included patients and 71 (12%) had a clinical diagnosis of COPD. Mean age was 69 ± 11 years and mean EF was 30 ± 9%. Thirty-two % of the patients were active smokers and 53% were previous smokers. Mean FEV1and FVC was 77.9 ± 1.7% and 85.4 ± 1.5% of predicted respectively. Obstructive pattern was observed in 233 (39%) of the patients. Of these, 53 patients (9%) had mild disease (GOLD I) and 180 (30%) patients had moderate to very severe disease (GOLD II-IV). No difference in spirometric variables was observed following up titration of medication.
  
  
  
  In stable patients with HF airflow obstruction is frequent and severely underdiagnosed. Spirometry should be considered in all patients with HF in order to improve diagnosis and treatment for concomitant pulmonary disease.
authors.affiliation: Department of Cardiology, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 75, Copenhagen, Denmark. md@dadlnet.dk.
authors.forename: Morten
authors.initials: M
authors.lastname: Dalsgaard
authors.affiliation: Department of Cardiology, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 75, Copenhagen, Denmark.
authors.forename: Louis Lind
authors.initials: LL
authors.lastname: Plesner
authors.affiliation: Department of Cardiology, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 75, Copenhagen, Denmark.
authors.forename: Morten
authors.initials: M
authors.lastname: Schou
authors.affiliation: Department of Cardiology, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 75, Copenhagen, Denmark.
authors.forename: Erik
authors.initials: E
authors.lastname: Kjøller
authors.affiliation: Department of Respiratory Medicine, Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.|Respiratory and Allergy Research Group, Manchester Academic Health Science Centre, University Hospital South Manchester NHS Foundation Trust, Manchester, UK.
authors.forename: Jørgen
authors.initials: J
authors.lastname: Vestbo
authors.affiliation: Department of Cardiology, Herlev Hospital, Copenhagen University Hospital, Herlev Ringvej 75, Copenhagen, Denmark.
authors.forename: Kasper
authors.initials: K
authors.lastname: Iversen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005541:Forced Expiratory Volume; D054143:Heart Failure, Systolic / Q000150:complications*; D006801:Humans; D016015:Logistic Models; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000453:epidemiology*; D057566:Self Report; D012907:Smoking / Q000453:epidemiology; D013147:Spirometry; D014797:Vital Capacity
keywords: COPD; Heart failure; Spirometry