European Heart Journal Advance Access originally published online on April 28, 2005
European Heart Journal 2005 26(18):1887-1894; doi:10.1093/eurheartj/ehi291
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Unrecognized heart failure in elderly patients with stable chronic obstructive pulmonary disease
1Utrecht Heart Failure Organisation (UHFO), Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85060, Stratenum 6.101, 3508 AB Utrecht, The Netherlands
2Heart Lung Center Utrecht, Department of Cardiology, University Medical Center Utrecht, PO Box 85500, 3508 9A Utrecht, The Netherlands
3Heart Lung Center Utrecht, Department of Pulmonary Diseases, University Medical Center Utrecht, PO Box 85500, 3508 9A Utrecht, The Netherlands
Received 16 November 2004; revised 23 February 2005; accepted 24 March 2005; online publish-ahead-of-print 28 April 2005.
* Corresponding author. Tel: +31 30 2538193; fax: +31 30 2539028. E-mail address: F.H.Rutten{at}umcutrecht.uu.nl
Aims To establish the prevalence of unrecognized heart failure in elderly patients with a diagnosis of chronic obstructive pulmonary disease, in a stable phase of their disease.
Methods and results In a cross-sectional study, patients 
65 years of age, classified as having chronic obstructive pulmonary disease by their general practitioner and not known with a cardiologist-confirmed diagnosis of heart failure, were invited to our out-patient clinic. Four hundred and five participants underwent an extensive diagnostic work-up, including medical history and physical examination, followed by chest radiography, electrocardiography, echocardiography, and pulmonary function tests. As reference (i.e. ‘gold’) standard the consensus opinion of an expert panel was used. The panel based the diagnosis of heart failure on all available results from the diagnostic assessment, guided by the diagnostic principles of the European Society of Cardiology (ESC) for heart failure (i.e., symptoms and echocardiographic systolic and/or diastolic dysfunction). The diagnosis of chronic obstructive pulmonary disease was based on the diagnostic criteria of the Global Initiative (GOLD) for chronic obstructive pulmonary disease. Of 405 participating patients with a diagnosis of chronic obstructive pulmonary disease, 83 (20.5%, 95% CI 16.7–24.8) had previously unrecognized heart failure (42 patients systolic, 41 ‘isolated’ diastolic, and none right-sided heart failure). In total, 244 (60.2%) patients had chronic obstructive pulmonary disease according to the GOLD criteria and 50 (20.5%, 95% CI 15.6–26.1) patients combined with unrecognized heart failure.
Conclusion Unrecognized heart failure is very common in elderly patients with stable chronic obstructive pulmonary disease. Closer co-operation among general practitioners, pulmonologists, and cardiologists is necessary to improve detection and adequate treatment of heart failure in this large patient population.
Key Words: Heart failure • Chronic obstructive pulmonary disease • Epidemiology • Prevalence • Primary care
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  L. C.M. Boudestein, F. H. Rutten, M. J. Cramer, J. W. J. Lammers, and A. W. Hoes The impact of concurrent heart failure on prognosis in patients with chronic obstructive pulmonary disease Eur J Heart Fail, November 3, 2009; (2009) hfp148v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. M. Hawkins, M. C. Petrie, P. S. Jhund, G. W. Chalmers, F. G. Dunn, and J. J.V. McMurray Heart failure and chronic obstructive pulmonary disease: diagnostic pitfalls and epidemiology Eur J Heart Fail, February 1, 2009; 11(2): 130 - 139. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. S. Buist Introduction. Proceedings of the ATS, December 1, 2008; 5(8): 796 - 799. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. R. J. Schermer, I. J. M. Smeele, B. P. A. Thoonen, A. E. M. Lucas, J. G. Grootens, T. J. van Boxem, Y. F. Heijdra, and C. van Weel Current clinical guideline definitions of airflow obstruction and COPD overdiagnosis in primary care Eur. Respir. J., October 1, 2008; 32(4): 945 - 952. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Authors/Task Force Members, K. Dickstein, A. Cohen-Solal, G. Filippatos, J. J.V. McMurray, P. Ponikowski, P. A. Poole-Wilson, A. Stromberg, D. J. van Veldhuisen, D. Atar, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM) Eur. Heart J., October 1, 2008; 29(19): 2388 - 2442. [Full Text] [PDF]
|
|
|
|
|
|
K. Dickstein, A. Cohen-Solal, G. Filippatos, J. J.V. McMurray, P. Ponikowski, P. A. Poole-Wilson, A. Stromberg, D. J. van Veldhuisen, D. Atar, A. W. Hoes, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM) Eur J Heart Fail, October 1, 2008; 10(10): 933 - 989. [Full Text] [PDF]
|
|
|
|
 |
|
 R. Debigare and F. Maltais Last Word on Point:Counterpoint: The major limitation to exercise performance in COPD is 1) inadequate energy supply to the respiratory and locomotor muscles, 2) lower limb muscle dysfunction, 3) dynamic hyperinflation J Appl Physiol, August 1, 2008; 105(2): 764 - 764. [Full Text] [PDF]
|
|
|
|
 |
|
 J. F. Donohue, N. A. Hanania, C. Fogarty, S. C. Campbell, M. Rinehart, and K. Denis-Mize Long-term safety of nebulized formoterol: Results of a twelve-month open-label clinical trial Therapeutic Advances in Respiratory Disease, August 1, 2008; 2(4): 199 - 208. [Abstract] [PDF]
|
|
|
|
 |
|
 J. N. Kirkpatrick, S. N. Ghani, and K. T. Spencer Hand carried echocardiography screening for LV systolic dysfunction in a pulmonary function laboratory Eur J Echocardiogr, May 1, 2008; 9(3): 381 - 383. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Agusti Physical Activity and Chronic Obstructive Pulmonary Disease Am. J. Respir. Crit. Care Med., April 1, 2008; 177(7): 675 - 676. [Full Text] [PDF]
|
|
|
|
|
|
H. Watz, B. Waschki, C. Boehme, M. Claussen, T. Meyer, and H. Magnussen Extrapulmonary Effects of Chronic Obstructive Pulmonary Disease on Physical Activity: A Cross-sectional Study Am. J. Respir. Crit. Care Med., April 1, 2008; 177(7): 743 - 751. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Derom, C. van Weel, G. Liistro, J. Buffels, T. Schermer, E. Lammers, E. Wouters, and M. Decramer Primary care spirometry Eur. Respir. J., January 1, 2008; 31(1): 197 - 203. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. M. Mannino and S. Braman The Epidemiology and Economics of Chronic Obstructive Pulmonary Disease Proceedings of the ATS, October 1, 2007; 4(7): 502 - 506. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Macchia, S. Monte, M. Romero, A. D'Ettorre, and G. Tognoni The prognostic influence of chronic obstructive pulmonary disease in patients hospitalised for chronic heart failure Eur J Heart Fail, September 1, 2007; 9(9): 942 - 948. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Mosterd and A. W Hoes Clinical epidemiology of heart failure Heart, September 1, 2007; 93(9): 1137 - 1146. [Full Text] [PDF]
|
|
|
|
|
|
F. H. Rutten, M.-J. M. Cramer, N. P.A. Zuithoff, J.-W. J. Lammers, W. Verweij, D. E. Grobbee, and A. W. Hoes Comparison of B-type natriuretic peptide assays for identifying heart failure in stable elderly patients with a clinical diagnosis of chronic obstructive pulmonary disease Eur J Heart Fail, June 1, 2007; 9(6-7): 651 - 659. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. D. Sin, E. Wong, I. Mayers, D. C. Lien, D. Feeny, H. Cheung, W. Q. Gan, and S. F. P. Man Effects of Nocturnal Noninvasive Mechanical Ventilation on Heart Rate Variability of Patients With Advanced COPD Chest, January 1, 2007; 131(1): 156 - 163. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Bursi, S. A. Weston, M. M. Redfield, S. J. Jacobsen, S. Pakhomov, V. T. Nkomo, R. A. Meverden, and V. L. Roger Systolic and diastolic heart failure in the community. JAMA, November 8, 2006; 296(18): 2209 - 2216. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. M. Jolobe Unrecognized heart failure in elderly patients with stable chronic obstructive pulmonary disease Eur. Heart J., February 1, 2006; 27(3): 372 - 372. [Full Text] [PDF]
|
|
|
|
|
|
F. H. Rutten, A. P.E. Sachs, J.-W. J. Lammers, and A. W. Hoes Unrecognized heart failure in elderly patients with stable chronic obstructive pulmonary disease: reply Eur. Heart J., February 1, 2006; 27(3): 372 - 373. [Full Text] [PDF]
|
|
|
|
|
|
M. A. Arias, A. Alonso-Fernandez, and F. Garcia-Rio Heart failure in elderly patients with chronic obstructive pulmonary disease Eur. Heart J., December 2, 2005; 26(24): 2743 - 2744. [Full Text] [PDF]
|
|
|
|
|
|
F. H. Rutten and A. W. Hoes Heart failure in elderly patients with chronic obstructive pulmonary disease: reply Eur. Heart J., December 2, 2005; 26(24): 2744 - 2744. [Full Text] [PDF]
|
|