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.
Significance of Patent Foramen Ovale in Patients with GOLD Stage II Chronic Obstructive Pulmonary Disease (COPD)
