B-type natriuretic peptides in chronic obstructive pulmonary disease: a systematic review

Hawkins, Nathaniel M.; Khosla, Amit; Virani, Sean; McMurray, John J.V.; FitzGerald, J. Mark

doi:10.1186/s12890-016-0345-7

Cited by 53 publications

(46 citation statements)

References 84 publications

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“…In addition, infection, a recognized precipitant of HF decompensation, was more frequently seen among the reasons for hospitalization in COPD vs. non‐COPD patients (32.6% vs. 17.1%, P < 0.001). COPD and its associated co‐morbidities may also be responsible for some additional chronic haemodynamic overload of the heart, as suggested by the significantly higher natriuretic peptide levels found in ambulatory HF patients with COPD vs. non‐COPD. This could partly explain and support the greater use of symptomatic medications and particularly diuretics in this group of patients, as discussed next, though definite conclusions regarding appropriateness cannot be drawn from these data.…”

Section: Discussionmentioning

confidence: 99%

Characteristics, treatments and 1‐year prognosis of hospitalized and ambulatory heart failure patients with chronic obstructive pulmonary disease in the European Society of Cardiology Heart Failure Long‐Term Registry

Canepa

Straburzyńska‐Migaj

Drożdż³

et al. 2017

European J of Heart Fail

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Aims To describe the characteristics and assess the 1‐year outcomes of hospitalized (HHF) and chronic (CHF) heart failure patients with chronic obstructive pulmonary disease (COPD) enrolled in a large European registry between May 2011 and April 2013. Methods and results Overall, 1334/6920 (19.3%) HHF patients and 1322/9409 (14.1%) CHF patients were diagnosed with COPD. In both groups, patients with COPD were older, more frequently men, had a worse clinical presentation and a higher prevalence of co‐morbidities. In HHF, the increase in the use of heart failure (HF) medications at hospital discharge was greater in non‐COPD than in COPD for angiotensin‐converting enzyme inhibitors (+13.7% vs. +7.2%), beta‐blockers (+20.6% vs. +11.8%) and mineralocorticoid receptor antagonists (+20.9% vs. +17.3%), thus widening the gap in HF treatment already existing between the two groups at admission. In CHF patients, there was a similar increase in the use of these medications after enrollment visit in the two groups, leaving a significant difference of 8.2% for beta‐blockers in favour of non‐COPD patients (89.8% vs. 81.6%, P < 0.001). At 1‐year follow‐up, the hazard ratios for COPD in multivariable analysis confirmed its independent association with hospitalizations both in HHF [all‐cause: 1.16 (1.04–1.29), for HF: 1.22 (1.05–1.42)] and CHF patients [all‐cause: 1.26 (1.13–1.41), for HF: 1.37 (1.17–1.60)]. The association between COPD and all‐cause mortality was not confirmed in both groups after adjustments. Conclusions COPD frequently coexists in HHF and CHF, worsens the clinical course of the disease, and significantly impacts its therapeutic management and prognosis. The matter should deserve greater attention from the cardiology community.

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Section: Discussionmentioning

confidence: 99%

Characteristics, treatments and 1‐year prognosis of hospitalized and ambulatory heart failure patients with chronic obstructive pulmonary disease in the European Society of Cardiology Heart Failure Long‐Term Registry

Canepa

Straburzyńska‐Migaj

Drożdż³

et al. 2017

European J of Heart Fail

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“…Unrecognized HF is unmanaged HF, but even the management of recognized HF in COPD patients is not informed by clinical trials, but rather is limited to small studies and is poorly disseminated [19]. COPD patients are consistently under-prescribed cardiovascular medications [5,20].…”

Section: Introductionmentioning

confidence: 99%

Hospitalisation and mortality in patients with comorbid COPD and heart failure: a systematic review and meta-analysis

et al. 2020

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Background: Discrepancy exists amongst studies investigating the effect of comorbid heart failure (HF) on the morbidity and mortality of chronic obstructive pulmonary disease (COPD) patients. Methods: MEDLINE and Embase were searched using a pre-specified search strategy for studies comparing hospitalisation, rehospitalisation, and mortality of COPD patients with and without HF. Studies must have reported crude and/or adjusted rate ratios, risk ratios, odds ratios (OR), or hazard ratios (HR). Results: Twenty-eight publications, reporting 55 effect estimates, were identified that compared COPD patients with HF with those without HF. One study reported on all-cause hospitalisation (1 rate ratio). Two studies reported on COPD-related hospitalisation (1 rate ratio, 2 OR). One study reported on COPD-or cardiovascular-related hospitalisation (4 HR). One study reported on 90-day all-cause rehospitalisation (1 risk ratio). One study reported on 3-year all-cause rehospitalisation (2 HR). Four studies reported on 30-day COPD-related rehospitalisation (1 risk ratio; 5 OR). Two studies reported on 1-year COPD-related rehospitalisation (1 risk ratio; 1 HR). One study reported on 3year COPD-related rehospitalisation (2 HR). Eighteen studies reported on all-cause mortality (1 risk ratio; 4 OR; 24 HR). Five studies reported on all-cause inpatient mortality (1 risk ratio; 4 OR). Meta-analyses of hospitalisation and rehospitalisation were not possible due to insufficient data for all individual effect measures. Meta-analysis of studies requiring spirometry for the diagnosis of COPD found that risk of all-cause mortality was 1.61 (pooled HR; 95%CI: 1.38, 1.83) higher in patients with HF than in those without HF. Conclusions: In this systematic review, we investigated the effect of HF comorbidity on hospitalisation and mortality of COPD patients. There is substantial evidence that HF comorbidity increases COPD-related rehospitalisation and all-cause mortality of COPD patients. The effect of HF comorbidity may differ depending on COPD phenotype, HF type, or HF severity and should be the topic of future research.

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“…In COPD patients, pulmonary hypertension is associated with vasoconstriction caused by chronic hypoxia [60]. In patients suffering from chronic obstructive pulmonary disease, BNP levels are often elevated especially with concomitant left hair failure (LHF), PAR and right heart remodelling [61] -these are diseases that often accompany COPD. In experiments on mice with pulmonary hypertension induced by chronic hypoxia, after administration of BNP (1.4 μg/min), a decrease in systolic pressure in the right ventricle and its mass was observed as compared to the control group.…”

Section: Vasodilation and Antiproliferative Activitymentioning

confidence: 99%

Neprilysin Inhibitors as a New Approach in the Treatment of Right Heart Failure in the Course of Chronic Obstructive Pulmonary Disease

Liczek¹,

Panek²,

Damiański³

et al. 2018

Advances in Respiratory Medicine

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The aim of the study was to find out scientific evidence on the possible use of the combined angiotensin II receptor antagonist and neprilysin inhibitors (ARNI) in patients with right heart failure (RHF) in the course of chronic obstructive pulmonary disease (COPD). It has been proven that a lack of neprilysin or its reduced expression in hypoxia leads to exacerbation of pulmonary arterial remodelling (PAR) or pulmonary hypertension (PH) in the mechanism related to the platelet-derived growth factor (PDGF) resulting in the proliferation and migration of pulmonary artery smooth muscle cells and endothelial-to-mesenchymal transition. Such action in the course of COPD can lead to RHF, which would signify noxious effect of this group of drugs. However, the inhibition of neprilysin also inhibits natriuretic peptide metabolism. The representative of this group - brain natriuretic peptide (BNP) - acts as a vasodilator and also exerts an anti-proliferative activity through the cGMP-dependent protein kinase G pathway. Additionally, it causes bronchodilation by inducing the release of acetylcholine from bronchial epithelial cells. This suggests that natriuretic peptides may appear to be a potential treatment agent in patients with cardiac complications and COPD. Their effects associated with the immunosuppression capacity by reducing the release of inflammatory mediators - IL-6, IL-1β, and TNF-α can bring benefits to patients with acute lung injury caused by pulmonary inflammation during COPD exacerbations. Considering the potentially positive effect of natriuretic peptides in this group of patients, further research is required in this area, which can provide strong scientific data demonstrating the need for introducing ARNI drugs to the treatment of patients with COPD.

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B-type natriuretic peptides in chronic obstructive pulmonary disease: a systematic review

Cited by 53 publications

References 84 publications

Characteristics, treatments and 1‐year prognosis of hospitalized and ambulatory heart failure patients with chronic obstructive pulmonary disease in the European Society of Cardiology Heart Failure Long‐Term Registry

Characteristics, treatments and 1‐year prognosis of hospitalized and ambulatory heart failure patients with chronic obstructive pulmonary disease in the European Society of Cardiology Heart Failure Long‐Term Registry

Hospitalisation and mortality in patients with comorbid COPD and heart failure: a systematic review and meta-analysis

Neprilysin Inhibitors as a New Approach in the Treatment of Right Heart Failure in the Course of Chronic Obstructive Pulmonary Disease

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