COPD: cardiac comorbidities often go undetected, untreated

  • Int J Chron Obstruct Pulmon Dis

  • von Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • About 13%-18% of patients with COPD have cardiac comorbidities.
  • One-third of study patients with abnormal echocardiography had no cardiovascular history or medication. 
  • Cardiac comorbidity makes a small contribution to exertional COPD symptoms.

Why this matters

  • Consider cardiac work-up for all patients with COPD.

Study design

  • COSYCONET COPD cohort with data on lung function and echocardiography (n=1591).
  • Abnormal echocardiography findings are left ventricular ejection fraction (LVEF) 56 mm.
  • Funding: German Federal Ministry of Education and Research Competence Network Asthma and COPD; Merck & Co., Inc., Kenilworth, NJ, USA; AstraZeneca; others.

Key results

  • Cardiac history (ischemic heart disease, myocardial infarction, or heart failure) was reported by 18.2% of the cohort.
  • Abnormal echocardiography was found in 12.8% of the cohort, of whom 36.3% had neither cardiovascular history nor medication.
  • Among the 59.6% of the cohort without isolated hypertension, 38.2% had LVEF 56 mm with neither cardiac diagnosis nor medication.
  • Left ventricular size was inversely correlated to exertional COPD symptoms, but the extent of the correlation was small (−0.078) compared with lung function (e.g., forced expiratory volume 1 correlation was −0.305).

Limitations

  • Observational design.