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The association between COPD and heart failure risk: a review

Authors de Miguel Díez J, Chancafe Morgan J, Jiménez García R

Received 28 February 2013

Accepted for publication 12 April 2013

Published 28 June 2013 Volume 2013:8 Pages 305—312

DOI https://doi.org/10.2147/COPD.S31236

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Javier de Miguel Díez,1 Jorge Chancafe Morgan,1 Rodrigo Jiménez García2

1Pulmonology Department, Gregorio Maranon University Hospital, Complutense University of Madrid, Madrid, Spain; 2Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Rey Juan Carlos University, Madrid, Spain

Abstract: Chronic obstructive pulmonary disease (COPD) is commonly associated with heart failure (HF) in clinical practice since they share the same pathogenic mechanism. Both conditions incur significant morbidity and mortality. Therefore, the prognosis of COPD and HF combined is poorer than for either disease alone. Nevertheless, usually only one of them is diagnosed. An active search for each condition using clinical examination and additional tests including plasma natriuretic peptides, lung function testing, and echocardiography should be obtained. The combination of COPD and HF presents many therapeutic challenges. The beneficial effects of selective ß1-blockers should not be denied in stable patients who have HF and coexisting COPD. Additionally, statins, angiotensin-converting enzyme inhibitors, and angiotensin-receptor blockers may reduce the morbidity and mortality of COPD patients. Moreover, caution is advised with use of inhaled ß2-agonists for the treatment of COPD in patients with HF. Finally, noninvasive ventilation, added to conventional therapy, improves the outcome of patients with acute respiratory failure due to hypercapnic exacerbation of COPD or HF in situations of acute pulmonary edema. The establishment of a combined and integrated approach to managing these comorbidities would seem an appropriate strategy. Additional studies providing new data on the pathogenesis and management of patients with COPD and HF are needed, with the purpose of trying to improve quality of life as well as survival of these patients.

Keywords: chronic obstructive pulmonary disease, heart failure

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