The diagnosis of COPD often remains unsuspected in patients with chronic heart failure (CHF), because the shortness of breath is attributed to CHF. We performed pulmonary function tests in 103 patients aged ≥65 years with a smoking history of ≥10 pack-years, who had received a new diagnosis of CHF the week before by a cardiologist. Each subject underwent accurate medical history and, besides N-terminal-pro-B-type natriuretic peptide (NT-pro-BNP) and echocardiography, we measured: body weight, body mass index (BMI), waist circumference, lipid, blood pressure, fasting glucose, and C-reactive protein (CRP). The left ventricular ejection fraction was ≤40% in 65 subjects and the NT-pro-BNP, measured in 96 patients, was >100 pg/mL in them all. Thirty patients (29%) received the diagnosis of concomitant COPD; all but two were unaware of the disease. 88 patients (85%) were overweight or obese with BMI of 25 kg/m2 or more. Metabolic syndrome was found in 57 subjects (55%) and treatment for type 2 diabetes was already ongoing in 25 (24%), whereas that for hypertension in 102 patients. CRP, measured in 75 subjects, was increased in 11 (15%). CRP showed a positive correlation with NT-pro-BNP (p= 0.01, r= 0.30) and a negative correlation with the diffusing capacity for carbon monoxide (p= 0.02, r= -0.30). We have shown that CHF delays the diagnosis of COPD and both are associated with other comorbid conditions. Lung function measurement, circulating inflammatory markers (CRP) and noninvasive assessment of metabolic function, besides that of cardiovascular function, might help to better characterise elderly patients with chronic polimorbidities. Supported by: MIUR and CFR.
Neglected COPD and chronic comorbidities in elderly patients with chronic heart failure
BOSCHETTO, Piera;BELTRAME, Daniela;POTENA, Alfredo;LO CASCIO, Natalina;MAPP, Cristina;DE ROSA, Edoardo;FUCILI, Alessandro;CECONI, Claudio;FERRARI, Roberto
2008
Abstract
The diagnosis of COPD often remains unsuspected in patients with chronic heart failure (CHF), because the shortness of breath is attributed to CHF. We performed pulmonary function tests in 103 patients aged ≥65 years with a smoking history of ≥10 pack-years, who had received a new diagnosis of CHF the week before by a cardiologist. Each subject underwent accurate medical history and, besides N-terminal-pro-B-type natriuretic peptide (NT-pro-BNP) and echocardiography, we measured: body weight, body mass index (BMI), waist circumference, lipid, blood pressure, fasting glucose, and C-reactive protein (CRP). The left ventricular ejection fraction was ≤40% in 65 subjects and the NT-pro-BNP, measured in 96 patients, was >100 pg/mL in them all. Thirty patients (29%) received the diagnosis of concomitant COPD; all but two were unaware of the disease. 88 patients (85%) were overweight or obese with BMI of 25 kg/m2 or more. Metabolic syndrome was found in 57 subjects (55%) and treatment for type 2 diabetes was already ongoing in 25 (24%), whereas that for hypertension in 102 patients. CRP, measured in 75 subjects, was increased in 11 (15%). CRP showed a positive correlation with NT-pro-BNP (p= 0.01, r= 0.30) and a negative correlation with the diffusing capacity for carbon monoxide (p= 0.02, r= -0.30). We have shown that CHF delays the diagnosis of COPD and both are associated with other comorbid conditions. Lung function measurement, circulating inflammatory markers (CRP) and noninvasive assessment of metabolic function, besides that of cardiovascular function, might help to better characterise elderly patients with chronic polimorbidities. Supported by: MIUR and CFR.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
