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COPD in patients with stable heart failure in the primary care setting.

Valk MJ, Broekhuizen BD, Mosterd A, Zuithoff NP, Hoes AW, Rutten FH - Int J Chron Obstruct Pulmon Dis (2015)

Bottom Line: Presence of chronic obstructive pulmonary disease (COPD) in heart failure (HF) has prognostic and therapeutic implications.Twenty-one (70%) of the 30 participants were newly detected cases of COPD.More than a quarter of the patients with HF concomitantly have COPD, with the large majority being previously unrecognized.

View Article: PubMed Central - PubMed

Affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Amersfoort, the Netherlands.

ABSTRACT

Background: Presence of chronic obstructive pulmonary disease (COPD) in heart failure (HF) has prognostic and therapeutic implications. Exact prevalence estimates are lacking because most previous studies estimated the prevalence of COPD among HF patients while unstable and in the presence of pulmonary congestion.

Methods: Community-dwelling patients with an established diagnosis of HF and in a stable phase of their disease were invited for spirometry. COPD was defined according to the Global initiative for chronic Obstructive Lung Disease (GOLD) classification and considered present if the ratio of the post-bronchodilator forced expiratory volume in 1 second and forced vital capacity was below 0.7.

Results: Thirty of the 106 patients with HF (mean age 76 [standard deviation] 11.9 years, 57% male) had COPD (prevalence 28.3% [95% confidence interval (CI) 19.7%-36.9%]), with similar rates among those with HF and a reduced ejection fraction (18 individuals; prevalence 28.6% [95% CI 20.0%-37.2%]) and HF with preserved ejection fraction (12 individuals; prevalence 27.9% [95% CI 19.4-36.4]). Twenty-one (70%) of the 30 participants were newly detected cases of COPD.

Conclusion: More than a quarter of the patients with HF concomitantly have COPD, with the large majority being previously unrecognized. Coexistence of COPD should be considered more often in these patients.

No MeSH data available.


Related in: MedlinePlus

Flow diagram.Abbreviation: HF, heart failure.
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f1-copd-10-1219: Flow diagram.Abbreviation: HF, heart failure.

Mentions: In a cross-sectional study we enrolled patients from 30 general practices from the vicinity of Amersfoort, the Netherlands. The study and recruitment period was from November 2010 until October 2011. In total 70,000 persons were enlisted in these practices. In the Netherlands all citizens are registered with a general practitioner (GP), irrespective of cooperative care by a hospital specialist, including those living in a home for the elderly, but excluding those living in a nursing home or hospice. Patients were eligible if they had a diagnosis of HF confirmed by an expert panel consisting of two cardiologists and a GP specializing in HF using all diagnostic information, including echocardiography. The panel based the diagnosis of HF on the criteria of the European Society of Cardiology, that is, suggestive symptoms and objective evidence of cardiac structural or functional cardiac abnormality related to ventricular dysfunction at rest detectable with echocardiography. For HF with reduced ejection fraction (HF-REF) the left ventricular ejection fraction should be <45%. For HF with preserved ejection fraction (HF-PEF) the left ventricular ejection fraction should be ≥45%, in addition to diastolic dysfunction identified by echocardiography.18 Disagreement between panel members was resolved by majority. We invited 236 patients with a confirmed diagnosis of HF for spirometry, and 121 (51.2%) consented to participate (Figure 1).


COPD in patients with stable heart failure in the primary care setting.

Valk MJ, Broekhuizen BD, Mosterd A, Zuithoff NP, Hoes AW, Rutten FH - Int J Chron Obstruct Pulmon Dis (2015)

Flow diagram.Abbreviation: HF, heart failure.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4492658&req=5

f1-copd-10-1219: Flow diagram.Abbreviation: HF, heart failure.
Mentions: In a cross-sectional study we enrolled patients from 30 general practices from the vicinity of Amersfoort, the Netherlands. The study and recruitment period was from November 2010 until October 2011. In total 70,000 persons were enlisted in these practices. In the Netherlands all citizens are registered with a general practitioner (GP), irrespective of cooperative care by a hospital specialist, including those living in a home for the elderly, but excluding those living in a nursing home or hospice. Patients were eligible if they had a diagnosis of HF confirmed by an expert panel consisting of two cardiologists and a GP specializing in HF using all diagnostic information, including echocardiography. The panel based the diagnosis of HF on the criteria of the European Society of Cardiology, that is, suggestive symptoms and objective evidence of cardiac structural or functional cardiac abnormality related to ventricular dysfunction at rest detectable with echocardiography. For HF with reduced ejection fraction (HF-REF) the left ventricular ejection fraction should be <45%. For HF with preserved ejection fraction (HF-PEF) the left ventricular ejection fraction should be ≥45%, in addition to diastolic dysfunction identified by echocardiography.18 Disagreement between panel members was resolved by majority. We invited 236 patients with a confirmed diagnosis of HF for spirometry, and 121 (51.2%) consented to participate (Figure 1).

Bottom Line: Presence of chronic obstructive pulmonary disease (COPD) in heart failure (HF) has prognostic and therapeutic implications.Twenty-one (70%) of the 30 participants were newly detected cases of COPD.More than a quarter of the patients with HF concomitantly have COPD, with the large majority being previously unrecognized.

View Article: PubMed Central - PubMed

Affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Amersfoort, the Netherlands.

ABSTRACT

Background: Presence of chronic obstructive pulmonary disease (COPD) in heart failure (HF) has prognostic and therapeutic implications. Exact prevalence estimates are lacking because most previous studies estimated the prevalence of COPD among HF patients while unstable and in the presence of pulmonary congestion.

Methods: Community-dwelling patients with an established diagnosis of HF and in a stable phase of their disease were invited for spirometry. COPD was defined according to the Global initiative for chronic Obstructive Lung Disease (GOLD) classification and considered present if the ratio of the post-bronchodilator forced expiratory volume in 1 second and forced vital capacity was below 0.7.

Results: Thirty of the 106 patients with HF (mean age 76 [standard deviation] 11.9 years, 57% male) had COPD (prevalence 28.3% [95% confidence interval (CI) 19.7%-36.9%]), with similar rates among those with HF and a reduced ejection fraction (18 individuals; prevalence 28.6% [95% CI 20.0%-37.2%]) and HF with preserved ejection fraction (12 individuals; prevalence 27.9% [95% CI 19.4-36.4]). Twenty-one (70%) of the 30 participants were newly detected cases of COPD.

Conclusion: More than a quarter of the patients with HF concomitantly have COPD, with the large majority being previously unrecognized. Coexistence of COPD should be considered more often in these patients.

No MeSH data available.


Related in: MedlinePlus