Diagnostic and Therapeutic Gaps in Patients With Heart Failure and Chronic Obstructive Pulmonary Disease

Publication date: October 2019Source: JACC: Heart Failure, Volume 7, Issue 10Author(s): Marco Canepa, Frits M.E. Franssen, Horst Olschewski, Mitja Lainscak, Michael Böhm, Luigi Tavazzi, Stephan RosenkranzAbstractHeart failure (HF) and chronic obstructive pulmonary disease (COPD) coincide in a significant number of patients. Recent population-based registries suggest that spirometry is largely underused in patients with HF to diagnose comorbid COPD and that patients with COPD frequently do not receive the recommended beta-blocker (BB) treatment. This state-of-the-art review summarizes: 1) current challenges in the implementation of recommended spirometry for COPD diagnosis in patients with HF; and 2) current underuse and underdosing of BBs in patients with HF and COPD despite guideline recommendations. Open issues in the therapeutic management of patients with HF and COPD are discussed in the third section, including the use of the nonselective BB carvedilol, target BB doses in patients with HF and COPD, BB and bronchodilator management during HF hospitalization with and without COPD exacerbation, and the use of BBs in patients with COPD with right HF or free from cardiovascular disease. The whole scenario described herein advocates for a bipartisan initiative to drive immediate attention to the translation of guideline recommendations into clinical practice for patients with HF with co-occurring COPD.Central Illustration
Source: JACC: Heart Failure - Category: Cardiology Source Type: research

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Publication date: Available online 11 September 2019Source: JACC: Heart FailureAuthor(s): Marco Canepa, Frits M.E. Franssen, Horst Olschewski, Mitja Lainscak, Michael Böhm, Luigi Tavazzi, Stephan RosenkranzAbstractHeart failure (HF) and chronic obstructive pulmonary disease (COPD) coincide in a significant number of patients. Recent population-based registries suggest that spirometry is largely underused in patients with HF to diagnose comorbid COPD and that patients with COPD frequently do not receive the recommended beta-blocker (BB) treatment. This state-of-the-art review summarizes 1) current challenges in the imp...
Source: JACC: Heart Failure - Category: Cardiology Source Type: research
ConclusionA case-finding strategy applied in primary care to multimorbid older people with dyspnoea or reduced exercise tolerance resulted in a number of new diagnoses of HF and COPD, but did not result in short-term improvement of health status compared to usual care.Trial registration.ClinicalTrials.gov NCT01148719
Source: American Heart Journal - Category: Cardiology Source Type: research
Heart failure (HF) and chronic obstructive pulmonary disease (COPD) are leading causes of death worldwide. Their prevalence is estimated as 1 –3% of the general population and 5–10% of adults, respectively [1]; these conditions often coexist, because smoking is a common risk factor, and low-grade systemic inflammation is a shared pathogenic mechanism. Prevalence estimates of comorbid HF and COPD vary widely according to cohort selecti on, age, risk factor exposure, and diagnostic criteria. When systematically employing spirometry, COPD was diagnosed in 36% of patients hospitalized for HF [2] and in 30% of stable HF patients [3].
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Editorial Source Type: research
Yafei Tan1,2, Omer Van den Bergh2, Jiang Qiu1* and Andreas von Leupoldt2* 1Faculty of Psychology, Southwest University, Chongqing, China 2Health Psychology, KU Leuven, Leuven, Belgium Dyspnea is a prevalent interoceptive sensation and the aversive cardinal symptom in many cardiorespiratory diseases as well as in mental disorders. Especially the unpredictability of the occurrence of dyspnea episodes has been suggested to be highly anxiety provoking for affected patients. Moreover, previous studies demonstrated that unpredictable exteroceptive stimuli increased self-reports and electrophysiological responses of an...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
Publication date: May 2019Source: The Lancet Global Health, Volume 7, Issue 5Author(s): MyLinh Duong, Shofiqul Islam, Sumathy Rangarajan, Darryl Leong, Om Kurmi, Koon Teo, Kieran Killian, Gilles Dagenais, Scott Lear, Andreas Wielgosz, Sanjeev Nair, Viswanathan Mohan, Prem Mony, Rajeev Gupta, Rajesh Kumar, Omar Rahman, Khalid Yusoff, Johannes Lodewykus du Plessis, Ehimario U Igumbor, Jephat ChifambaSummaryBackgroundThe associations between the extent of forced expiratory volume in 1 s (FEV1) impairment and mortality, incident cardiovascular disease, and respiratory hospitalisations are unclear, and how these associations mi...
Source: The Lancet Global Health - Category: International Medicine & Public Health Source Type: research
CONCLUSION: The prevalence of airflow limitation in patients with HF is high, with a significant degree of underdiagnosis. It seems reasonable to recommend performing a screening spirometry in these patients. PMID: 30616915 [PubMed - as supplied by publisher]
Source: Medicina Clinica - Category: General Medicine Tags: Med Clin (Barc) Source Type: research
Abstract BACKGROUND: Chronic obstructive pulmonary disease (COPD), a known risk factor for the development of congestive heart failure (CHF), was recently shown to predict the prevalence of atrial fibrillation (AF). Here, we explore the influence of AF on cardiac prognosis in COPD patients. METHODS: A total of 339 consecutive patients who underwent spirometry from 2010 to 2013 for various reasons were retrospectively examined. Based on the diagnostic criteria, patients were stratified into COPD and non-COPD groups, which were both further divided into those with AF (chronic AF or paroxysmal AF) or sinus rhyth...
Source: Indian Heart J - Category: Cardiology Authors: Tags: Indian Heart J Source Type: research
Publication date: Available online 1 December 2018Source: Indian Heart JournalAuthor(s): Tomoko Tomioka, Kento Fukui, Syuhei Tanaka, Yoshitaka Ito, Hiroki Shioiri, Jiro Koyama, Kanichi InoueAbstractBackgroundChronic obstructive pulmonary disease (COPD), a known risk factor for the development of congestive heart failure (CHF), was recently shown to predict the prevalence of atrial fibrillation (AF). Here, we explore the influence of AF on cardiac prognosis in COPD patients.MethodsA total of 339 consecutive patients who underwent spirometry from 2010 to 2013 for various reasons were retrospectively examined. Based on the di...
Source: Indian Heart Journal - Category: Cardiology Source Type: research
Authors: Eriksson B, Backman H, Ekerljung L, Axelsson M, Lindberg A, Rönmark E, Lundbäck B Abstract Cardiovascular diseases are the most common comorbidities in COPD, due to common risk factors such as smoking. The prevalence of current smokers in Sweden has decreased over four decades to around 10%. The aim of the present study was to investigate the prevalence, distribution and associations of cardiovascular comorbidities in COPD by disease severity in two large areas of Sweden, both with low-smoking prevalence. Data from clinical examinations in 2009-2012, including spirometry and structured interview,...
Source: COPD: Journal of Chronic Obstructive Pulmonary Disease - Category: Respiratory Medicine Tags: COPD Source Type: research
Background: The majority of patients with COPD have at least one comorbid condition which further complicates the evolution and the management of the disease. The aim of the study was to evaluate and to analyze the prevalence and clinical significance of COPD comorbidities.Methods: The study was conducted in 435 patients with COPD. Spirometric data were analyzed (FEV1, FVC, FEV1/FVC) and BODE, ADO, BODEx, CODEX and DOSE index.Results: Patients had heart failure in 38.62%, hypertension in 50.11%, coronary artery disease in 23.45%, diabetes mellitus in 10.11%, renal failure in 1.15%, rheumatoid arthritis in 3.22%, depression...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical Problems Source Type: research
More News: Beta-Blockers | Cardiology | Cardiovascular | Chronic Obstructive Pulmonary | Coreg | Heart | Heart Failure | Spirometry