Abstract
Rationale: A substantial prevalence of heart failure is reported for COPD. Due to the overlap of symptoms, detection of the predominant underlying disease and its contribution to symptoms remains challenging. Cardiovascular medication may alleviate symptoms, depending on type and severity of the cardiac disorder. To disentangle these factors we examined the COPD cohort COSYCONET.
Methods: Patients with data on lung function, including FEV1, the RV/TLC ratio, diffusing capacity TLCO, and echocardiographic data, including left ventricular ejection fraction (LVEF), enddiastolic diameter (LVEDD), medical history, medication, mMRC and SGRQ were analyzed, including structural equation modelling (SEM).
Results: 1591 patients (GOLD 0-4: n=230/126/614/498/123) fulfilled the inclusion criteria. Ischemic heart disease, myocardial infarction or heart failure were reported in 289 patients (18.2%) and 860 (54%) patients received at least one cardiovascular medication, with each more than one in many patients. LVEF<50% or LVEDD>56 mm occurred in 204 patients (12.8%), of whom 74 (36.3%) had neither a cardiovascular history nor medication. We excluded patients with hypertension without other cardiovascular disease. Among the remaining 948 patients (59.6%) there were 21/55 (38.2%) patients with LVEF<50% and 47/88 (53.4%) with LVEDD>56 mm, who lacked both a cardiac diagnosis and medication. Beyond the dominant effect of lung function on symptoms (mMRC and SGRQ), the SEM revealed an independent link from LVEDD.
Conclusion: A remarkable proportion of patients with suspicious echocardiographic findings appears undiagnosed and untreated. LVEDD was directly associated with COPD symptoms.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, OA479.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019