Cardiovascular function and prognosis of patients with heart failure coexistent with chronic obstructive pulmonary disease

Yoshihisa, Akiomi; Takiguchi, Masafumi; Shimizu, Takeshi; Nakamura, Yūichi; Yokota, Hiroyuki; Iwaya, Shoji; Owada, Takashi; Miyata, Makiko; Abe, Satoshi; Sato, Toshio; Suzuki, Satoshi; Oikawa, Masayoshi; Kobayashi, Atsushi; Yamaki, Takashi; Sugimoto, Koichi; Kunii, Hiroyuki; Nakazato, Kazuhiko; Suzuki, Hitoshi; Saitoh, Shu‐ichi; Takeishi, Yasuchika

doi:10.1016/j.jjcc.2014.02.003

Cited by 58 publications

(65 citation statements)

References 41 publications

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“…But, we could collect the previous year’s information of hospitalization due to AECOPD; therefore, frequent exacerbators were defined as patients who had at least one hospitalization for AECOPD in the past year. We did find that AECOPD patients with coexisting congestive heart failure had higher 1-year and in-hospital death, which was consistent with previous studies 22,23…”

Section: Discussionsupporting

confidence: 93%

Prognostic role of D-dimer for in-hospital and 1-year mortality in exacerbations of COPD

Zhou

et al. 2016

COPD

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Background and objectiveSerum D-dimer is elevated in respiratory disease. The objective of our study was to investigate the effect of D-dimer on in-hospital and 1-year mortality after acute exacerbations of chronic obstructive pulmonary disease (AECOPD).MethodsUpon admission, we measured 343 AECOPD patients’ serum D-dimer levels and arterial blood gas analysis, and recorded their clinical characteristics. The level of D-dimer that discriminated survivors and non-survivors was determined using a receiver operator curve (ROC). The risk factors for in-hospital mortality were identified through univariate analysis and multiple logistic regression analyses. To evaluate the predictive role of D-dimer for 1-year mortality, univariate and multivariate Cox regression analyses were performed.ResultsIn all, 28 patients died, and 315 patients survived in the in-hospital period. The group of dead patients had lower pH levels (7.35±0.11 vs 7.39±0.05, P<0.0001), higher D-dimer, arterial carbon dioxide tension (PaCO2), C-reactive protein (CRP), and blood urea nitrogen (BUN) levels (D-dimer 2,244.9±2,310.7 vs 768.2±1,078.4 µg/L, P<0.0001; PaCO2: 58.8±29.7 vs 46.1±27.0 mmHg, P=0.018; CRP: 81.5±66, P=0.001; BUN: 10.20±6.87 vs 6.15±3.15 mmol/L, P<0.0001), and lower hemoglobin levels (118.6±29.4 vs 128.3±18.2 g/L, P=0.001). The areas under the ROC curves of D-dimer for in-hospital death were 0.748 (95% confidence interval (CI): 0.641–0.854). D-dimer ≥985 ng/L was a risk factor for in-hospital mortality (relative risk =6.51; 95% CI 3.06–13.83). Multivariate logistic regression analysis also showed that D-dimer ≥985 ng/L and heart failure were independent risk factors for in-hospital mortality. Both univariate and multivariate Cox regression analyses showed that D-dimer ≥985 ng/L was an independent risk factor for 1-year death (hazard ratio (HR) 3.48, 95% CI 2.07–5.85 for the univariate analysis; and HR 1.96, 95% CI 1.05–3.65 for the multivariate analysis).ConclusionD-dimer was a strong and independent risk factor for in-hospital and 1-year death for AECOPD patients.

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Section: Discussionsupporting

confidence: 93%

Prognostic role of D-dimer for in-hospital and 1-year mortality in exacerbations of COPD

Zhou

et al. 2016

COPD

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“…The RV‐FAC, defined as (end‐diastolic area ‐ end‐systolic area)/end‐diastolic area × 100, was used as a measure of right ventricular systolic function. All measurements were performed using ultrasound systems (ACUSON Sequoia, Siemens Medical Solutions USA, Inc, Mountain View, CA, USA) …”

Section: Methodsmentioning

confidence: 99%

Plasma levels of melatonin in dilated cardiomyopathy

Misaka

Yoshihisa

Yokokawa

et al. 2019

Journal of Pineal Research

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Background Melatonin is a multifunctional indolamine and has a cardioprotective role in a variety of cardiovascular processes via antioxidant, anti‐inflammatory, antihypertensive, antithrombotic, and antilipemic effects. It has been reported that lower levels of circulating melatonin are significantly associated with a higher risk of acute myocardial infarction (AMI) and later cardiac remodeling. However, levels of melatonin in patients with dilated cardiomyopathy (DCM) and associations between melatonin levels and cardiac function remain unclear. Methods and Results We measured and compared plasma levels of melatonin in 61 control subjects, 81 AMI patients, and 77 DCM patients. Plasma levels of melatonin were progressively decreased from 71.9 pg/mL in the control group to 52.6 pg/mL in the DCM group and 21.9 pg/mL in the AMI group. Next, we examined associations of melatonin levels with parameters of laboratory data, echocardiography, and right‐heart catheterization. In the DCM patients, circulating melatonin showed significant correlations with both high‐sensitivity troponin T ( R = −0.422, P < 0.001) and cardiac output ( R = 0.431, P = 0.003), but not with B‐type natriuretic peptide (BNP), left ventricular ejection fraction (LVEF), pulmonary artery wedge pressure, or pulmonary artery pressure. Conclusion Patients with not only AMI but also DCM had lower circulating melatonin levels. Circulating melatonin levels appear to correlate with myocardial injury and cardiac output in DCM patients.

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“…The prescribing of β-blockers was particularly low for patients with COPD but was comparable with other studies. 7,8 However, adjustment did not explain the association between COPD and risk of mortality or hospitalization.…”

Section: Discussionmentioning

confidence: 94%

“…Prevalence of COPD in the community was similar to other clinical database studies 5,8 but was much lower than in HF studies using formal spirometry screening, which indicates a potential prevalence of up to 40%. 6,7,10 This means the number of patients with HF and COPD in the community is likely to be much higher than was recorded, 24,25 with a potentially even greater effect on outcomes. The prescribing of β-blockers was particularly low for patients with COPD but was comparable with other studies.…”

Section: Discussionmentioning

confidence: 99%

Association of Medication Intensity and Stages of Airflow Limitation With the Risk of Hospitalization or Death in Patients With Heart Failure and Chronic Obstructive Pulmonary Disease

et al. 2018

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Key Points Question Who are the highest risk heart failure (HF) patients with chronic obstructive pulmonary disease (COPD)? Findings In this nested case-control study of more than 50 000 UK patients with HF, COPD increased the risk of hospital admission and death by more than a third, but increased risk was specific to patients receiving the most intense COPD medication regimens: triple inhaler therapy, prescribed oral corticosteroids, or oxygen therapy. Spirometry recording was limited in the community setting was restricted to more severe patients with HF and COPD, and for these patients the risk of mortality significantly increased alongside increasing airway limitation. Meaning Optimal care of patients with HF and COPD requires accurate diagnosis and targeting of severe COPD markers to prevent admissions and death.

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Cardiovascular function and prognosis of patients with heart failure coexistent with chronic obstructive pulmonary disease

Abstract: HF patients with coexistent moderate COPD (GOLD stage II) have greater myocardial damage, greater arterial stiffness, and higher cardiac and non-cardiac mortality.

Cited by 58 publications

References 41 publications

Prognostic role of D-dimer for in-hospital and 1-year mortality in exacerbations of COPD

Prognostic role of D-dimer for in-hospital and 1-year mortality in exacerbations of COPD

Plasma levels of melatonin in dilated cardiomyopathy

Association of Medication Intensity and Stages of Airflow Limitation With the Risk of Hospitalization or Death in Patients With Heart Failure and Chronic Obstructive Pulmonary Disease

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