Abstract 11292: Impact of Chronic Obstructive Pulmonary Disease on Cardiovascular Function and Prognosis in Heart Failure Patients

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Takeshi Shimizu ◽  
Akiomi Yoshihisa ◽  
Mai Takiguchi ◽  
Minoru Nodera ◽  
Shunsuke Miura ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Troponin T ◽  
Stage Ii ◽  
Chronic Obstructive ◽  
Estimated Gfr ◽  
Obstructive Pulmonary Disease ◽  
Gold Stage ◽  
All Cause Mortality

Background: Chronic obstructive pulmonary disease (COPD) often coexists with heart failure (HF), and is thought to have a critical association with mortality and morbidity in HF patients. However, the impact of COPD on cardiovascular function and the detailed all-cause mortality of HF remain unclear. Methods and Results: Consecutive 378 patients admitted for HF who underwent spirometry were divided into 3 groups: HF without COPD (Non-COPD group, n = 272), HF with mild COPD (GOLD I group, n = 82), and HF with moderate COPD (GOLD II group, n = 24). We compared echocardiographic findings, vascular function including flow mediated dilatation (FMD) and cardio-ankle vascular index and circulating levels of troponin T, BNP, CRP, and estimated GFR among the three groups. The GOLD II group, as compared to Non-COPD group, had 1) higher troponin T (0.030 vs. 0.020 ng/ml, P = 0.009), 2) greater cardio-ankle vascular index (8.99 vs. 8.29, P = 0.032), 3) similar levels of FMD, BNP, CRP, and estimated GFR, and 4) similar cardiac systolic and diastolic function of the right and left ventricle. In addition, rates of cardiac (P = 0.049), non-cardiac (P = 0.001), and all-cause mortality (P = 0.002) were higher in GOLD II group than in Non-COPD and GOLD I groups. Importantly, in the Cox proportional hazard analyses, the GOLD stage II was an independent predictor of cardiac (P = 0.038), non-cardiac (P = 0.036), and all-cause mortality (P = 0.015) in HF patients. Conclusions: HF patients with coexistent moderate COPD (GOLD stage II) have greater myocardial damage, greater arterial stiffness, and higher cardiac and non-cardiac mortality. Thus, taking appropriate management to control COPD may improve the prognosis of HF patients with COPD.

Abstract 16961: Time-dependent Markers of Chronic Obstructive Pulmonary Disease Severity and Change are Associated With Increased Risk of Mortality in the General Heart Failure Population: A National Study of 50,114 Patients From the United Kingdom

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Claire A Rushton ◽  
Lucy Riley ◽  
Duwarakan K Satchithananda ◽  
Peter W Jones ◽  
Umesh T Kadam
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Forced Expiration ◽  
Obstructive Pulmonary Disease ◽  
Gold Stage ◽  
Risk Of Mortality ◽  
Increased Risk

Purpose: Heart failure (HF) carries poor prognosis which changes over time. Chronic obstructive pulmonary disease (COPD) is common in HF and increases risk of mortality but how COPD severity and change influences HF prognosis is unknown. We hypothesised that in the HF general population, comorbidity stratification by increasing severity and longitudinal change would be associated with increased mortality. Methods: We used a case-control study nested within the UK Clinical Practice Research Datalink database (12-year time-period to 2014), of newly diagnosed HF patients aged over 40 years. Using risk set sampling, four controls were matched to cases on calendar and follow-up time. Routinely collected clinical measures of severity and change for COPD were (i) forced expiration volume in 1 second (FEV 1 ) stages, defined by Global Initiatives for Chronic Obstructive Lung Disease (GOLD) guidelines and (ii) prescribed medications in two time-windows covering 1-year prior to the match date. Conditional logistic regression was used to estimate risk ratios (RR) for all-cause mortality adjusted for known confounders. Results: Of the 50,114 HF sample, 5,848 (11.7%) had COPD and of these 62% died during follow-up compared to 52% of patients without COPD. COPD comorbidity risk associated with mortality stratified by GOLD stages was as follows: stage 1; adjusted RR 1.73 (95% CI 1.50-1.99) to stage 4; 3.14 (2.65, 3.73). Estimates for COPD FEV 1 change compared to no COPD were: GOLD stage same or better; 2.15 (1.97, 2.34) and GOLD stage worse; 2.70 (2.30, 3.17). The mortality estimates for medications severity were: inhalers only 1.13 (1.07,1.19), oral steroids; 1.83 (1.69,1.97) and oxygen; 2.94 (2.47, 3.51). The estimates for medications change were: no new steroids or oxygen; 1.22, (1.16, 1.28), new steroids but not oxygen; 1.84, (1.67,1.28) and new on oxygen; 3.41, (2.71,4.29). Conclusions: COPD is an important and common comorbidity in HF. Our results show that worse COPD severity and recent change based on routinely collected clinical data was associated with increased mortality and provides key prognostic information for clinical assessment in practice.

scholarly journals Different Impact of Beta-Blockers on Long-Term Mortality in Heart Failure Patients with and without Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 10 (19) ◽  
pp. 4378
Author(s):  
Satoshi Higuchi ◽  
Takashi Kohno ◽  
Shun Kohsaka ◽  
Yasuyuki Shiraishi ◽  
Makoto Takei ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Beta Blockers ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Chronic Obstructive ◽  
Cardiac Mortality ◽  
Obstructive Pulmonary Disease ◽  
All Cause Mortality

The administration of beta-blockers is challenging and their efficacy is unclear in heart failure (HF) patients with chronic obstructive pulmonary disease (COPD). This study aimed to investigate the association of beta-blockers with mortality in such patients. This multicenter observational cohort study included hospitalized HF patients with a left ventricular ejection fraction <50% and evaluated them retrospectively. COPD was diagnosed based on medical records and/or the clinical judgment of each investigator. The study endpoints were two-year all-cause, cardiac, and non-cardiac mortality. This study included 83 patients with COPD and 1760 patients without. Two-year all-cause, cardiac, and non-cardiac mortality were observed in 315 (17%), 149 (8%), and 166 (9%) patients, respectively. Beta-blockers were associated with lower all-cause mortality regardless of COPD (COPD: hazard ratio [HR] 0.39, 95% CI 0.16–0.98, p = 0.044; non-COPD: HR 0.62, 95% CI 0.46–0.83, p = 0.001). This association in HF patients with COPD persisted after multivariate analysis and inverse probability weighting and was due to lower non-cardiac mortality (HR 0.40, 95% CI 0.14–1.18. p = 0.098), not cardiac mortality (HR 0.37, 95% CI 0.07–2.01, p = 0.248). Beta-blockers were associated with lower all-cause mortality in HF patients with COPD due to lower non-cardiac mortality. This may reflect selection biases in beta-blocker prescription.

Abstract TP357: Risk Factors of Stroke Among Community- residing Patients with Chronic Obstructive Pulmonary Disease (copd)

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Hee-Young Song
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Stroke Risk ◽  
Stage Ii ◽  
Stage Iii ◽  
Anthropometric Measurement ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Gold Stage

Introduction: Worldwide, chronic obstructive pulmonary disease (COPD) and stroke are leading causes of death. Increasing evidence suggests that COPD patients have a higher risk of stroke than the general population Objectives: This study was undertaken to investigate risk factors of stroke including concurrent cardiovascular disease(CVD); to explore differences of these variables and their relationships according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage among community-residing patients with COPD. Methods: A total of 118 participants with mean aged 69.4 years old were recruited among those patients with COPD who have been treated at the outpatient department of pulmonology at a University hospital in an urban area of South Korea. Along with BP and anthropometric measurement, trained interviewers interviewed participants with a structured questionnaire including demographic characteristics, lifestyle risk factors, and comorbid CVD. Data were analyzed using SPSS statistics 20.0 Results: Most of participants (89.8%) were men, almost half (50.4%) of them were categorized into GOLD stage II, and 39.3 % and 10.3 % of them were GOLD stage III and IV, respectively. Mean systolic BP of participants was 123.8 mmHg and mean diastolic BP, 80.3 mmHg. Seventy percent of them were currently non-smoker and 45% of them did not drink. Sixty eight percent of them had no CVD, while 32% of them had been diagnosed with and treated due to hypertension, atrial fibrillation, or coronary artery diseases. The duration of COPD diagnosis was significantly shorter among those who had comorbid CVD. There were no significant differences in histories of smoking or drinking according to the GOLD stages. However, those in GOLD stage II had more CVD than those in COLD stage III and IV. Also, age and BMI showed significant differences according to the GOLD stages. Conclusions: The findings demonstrated the presences of stroke risk factors and possible associations between some risk factors, such as comorbid CVD, and COPD severity among patients with COPD. Further research is needed to explore the precise relationships among stroke risk, concurrent CVD, and the severity, duration, treatment of exacerbations of COPD among this population.

Prevalence and Prognostic Impact of Chronic Obstructive Pulmonary Disease in Patients with Chronic Heart Failure: Data from the GISSI-HF Trial

Cardiology ◽  
2016 ◽  
Vol 136 (2) ◽  
pp. 128-137 ◽  
Author(s):  
Marco Canepa ◽  
Pier Luigi Temporelli ◽  
Andrea Rossi ◽  
Andrea Rossi ◽  
Lucio Gonzini ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Independent Predictor ◽  
Primary Study ◽  
Chronic Obstructive ◽  
Prognostic Impact ◽  
Obstructive Pulmonary Disease ◽  
Failure Data ◽  
All Cause Mortality

Objectives: Chronic obstructive pulmonary disease (COPD) is a common comorbidity in patients with heart failure (HF). We aimed to assess its prevalence, characterization and long-term prognostic impact in the GISSI-HF population. Methods: The study randomized 6,975 ambulatory HF patients to either n-3 polyunsaturated fatty acids or placebo. We performed a retrospective analysis of clinical characteristics and outcomes of the 1,533 patients diagnosed with COPD (22%). Results: COPD was associated with a worse clinical presentation and an increased burden of comorbidities. At a median follow-up of 3.9 years, COPD was found to be an independent predictor of both predefined primary study end points, including all-cause mortality (HR 1.28, 95% CI 1.15-1.43, p < 0.0001) and all-cause mortality or hospitalization for cardiovascular reasons (HR 1.19, 95% CI 1.10-1.30, p < 0.0001). Both cardiovascular (HR 1.20, 95% CI 1.05-1.36, p = 0.007) and noncardiovascular mortality (HR 1.56, 95% CI 1.26-1.94, p < 0.0001) were significantly increased in COPD-HF patients, as well as hospitalizations for any reason (HR 1.23, 95% CI 1.14-1.34, p < 0.0001), for cardiovascular reasons (HR 1.16, 95% CI 1.06-1.27, p = 0.002) and for HF (HR 1.27, 95% CI 1.14-1.43, p < 0.0001). Conclusions: COPD is an independent predictor of mortality and hospitalizations in ambulatory HF patients. Increased awareness and improved management of COPD may reduce the burden of this morbidity to patients with HF.

Clinical options for the course of chronic heart failure in combination with chronic obstructive pulmonary disease

2019 ◽  
Vol 17 (2) ◽  
pp. 58-63
Author(s):  
V. M. Gazizyanova ◽  
◽  
O. V. Bulashova ◽  
E. V. Khazova ◽  
N. R. Khasanov ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Chronic Heart Failure ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Tolerability of carvedilol in patients with heart failure and concomitant chronic obstructive pulmonary disease or asthma

2002 ◽  
Vol 21 (12) ◽  
pp. 1290-1295 ◽  
Author(s):  
Eugene Kotlyar ◽  
Anne M Keogh ◽  
Peter S Macdonald ◽  
Ruth H Arnold ◽  
Dermot J McCaffrey ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Patients With Heart Failure
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