Italian survey on prevalence and disease management of chronic heart failure and chronic obstructive pulmonary disease comorbidity in ambulatory patients. SUSPIRIUM study rationale and design

Griffo, Raffaele; Spanevello, Antonio; Temporelli, Pier Luigi; Faggiano, Pompilio; Carone, Mauro; Magni, Giovanna; Ambrosino, Nicolino; Tavazzi, Luigi

doi:10.4081/monaldi.2014.40

Cited by 4 publications

(4 citation statements)

References 20 publications

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“…In this regard, meta-analyses assessing broadly framed questions may assemble highly heterogeneous studies, especially when addressing the prevalence of phenomena in heterogeneous diseases such as asthma [ 77 , 98 ]. Furthermore, the assessment of comorbid disorders greatly varies across the studies depending on the analysed population, diagnostic criteria and measurement tools [ 99 ]. Besides, observational studies are not always specifically designed to assess comorbidities as primary outcomes; therefore, we must acknowledge that the estimated odds ratios might be partly affected by lack of precision and potentially by diagnostic confusion, as a result of miscoding in claims-based patient treatment records.…”

Section: Discussionmentioning

confidence: 99%

Strength of association between comorbidities and asthma: a meta-analysis

et al. 2023

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BackgroundThe strength of association between comorbidities and asthma has never been ranked in relation to the prevalence of the comorbidity in the nonasthma population. We investigated the strength of association between comorbidities and asthma.MethodsA comprehensive literature search was performed for observational studies reporting data on comorbidities in asthma and nonasthma populations. A pairwise meta-analysis was performed and the strength of association calculated by anchoring odds ratios and 95% confidence intervals with the rate of comorbidities in nonasthma populationsviaCohen'sdmethod. Cohen'sd=0.2, 0.5 and 0.8 were cut-off values for small, medium and large effect sizes, respectively; very large effect size resulted for Cohen'sd >0.8. The review was registered in the PROSPERO database; identifier number CRD42022295657.ResultsData from 5 493 776 subjects were analysed. Allergic rhinitis (OR 4.24, 95% CI 3.82–4.71), allergic conjunctivitis (OR 2.63, 95% CI 2.22–3.11), bronchiectasis (OR 4.89, 95% CI 4.48–5.34), hypertensive cardiomyopathy (OR 4.24, 95% CI 2.06–8.90) and nasal congestion (OR 3.30, 95% CI 2.96–3.67) were strongly associated with asthma (Cohen'sd>0.5 and ≤0.8); COPD (OR 6.23, 95% CI 4.43–8.77) and other chronic respiratory diseases (OR 12.85, 95% CI 10.14–16.29) were very strongly associated with asthma (Cohen'sd>0.8). Stronger associations were detected between comorbidities and severe asthma. No bias resulted according to funnel plots and Egger's test.ConclusionThis meta-analysis supports the relevance of individualised strategies for disease management that look beyond asthma. A multidimensional approach should be used to assess whether poor symptom control is related to uncontrolled asthma or to uncontrolled underlying comorbidities.

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Section: Discussionmentioning

confidence: 99%

Strength of association between comorbidities and asthma: a meta-analysis

et al. 2023

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“…The study protocol has been published elsewhere. 19 In brief, SUSPIRIUM was a cross-sectional observational prospective multicentre nationwide survey involving 20 outpatient units: 10 cardiac and 10 ‘sister’ respiratory units from the same institution. Data were collected on-line.…”

Section: Methodsmentioning

confidence: 99%

Frequent coexistence of chronic heart failure and chronic obstructive pulmonary disease in respiratory and cardiac outpatients: Evidence from SUSPIRIUM, a multicentre Italian survey

Griffo

Spanevello

Temporelli

et al. 2017

Eur J Prev Cardiolog

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Background Chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) frequently coexist but concurrent COPD + CHF has been little investigated. Design This multicentre survey (SUSPIRIUM) was designed to evaluate: the prevalence of COPD in stable CHF and CHF in stable COPD; diagnostic/therapeutic work-up for concurrent COPD + CHF; clinical profile of patients with COPD + CHF; predictors of COPD in CHF and CHF in COPD. Methods A 5-month-long cross-sectional prospective observational survey was conducted in 10 cardiac and 10 respiratory connected outpatient units. Results The prevalence of CHF in the 378 surveyed COPD patients was 11.9% (95% confidence interval 8.8-16.6) and the prevalence of COPD in 375 CHF patients was 31.5% (95% confidence interval 26.8-36.4). Diagnostic tests for suspected comorbidity were prescribed in 21.6% and 22.9% of COPD and CHF patients, respectively. Patients with coexisting CHF + COPD had a higher incidence of hypertension, physical inactivity and more frequently a GOLD score of 3 or greater. Compared to CHF only, CHF + COPD patients were significantly older, more frequently smokers, at worse respiratory risk and in a higher New York Heart Association class. Conversely, hypercholesterolaemia, a family history of ischaemic heart disease, fluid retention and comorbidities were more frequent in COPD + CHF than COPD-only patients. At multivariate analysis, a GOLD score of 3 or greater in CHF strongly predicted coexistent COPD (odds ratio 8.985, P < 0.0001) as did a history of other respiratory diseases (5.184, P < 0.0001). A history of ischaemic heart disease (4.868, P < 0.0001), atrial fibrillation (3.302, P < 0.0001) and sedentary lifestyle (2.814, P < 0.004) predicted coexistent CHF in COPD. Conclusion The high prevalence of COPD + CHF calls for integrated disease management between cardiologists and pulmonologists. SUSPIRIUM identifies which cardiac/pulmonary outpatients should be screened for the respective comorbidity.

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“…Chronic obstructive pulmonary disease (COPD) and heart failure (HF) coexist not because of their high individual prevalence, but because both share common etiological and pathophysiological factors, such as smoking and systemic inflammation [1][2][3] . COPD overlap syndrome in HF can reach up to 30% 4 . The prevalence of COPD in patients hospitalized for HF is 10%, and the risk of developing HF during hospitalization due to COPD decompensation is 4.5% 5 .…”

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confidence: 99%

The Value of Cardiopulmonary Exercise Testing in Determining Severity in Patients with both Systolic Heart Failure and COPD

Goulart

Santos

Caruso

et al. 2020

Sci Rep

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our aim was to identify optimal cardiopulmonary exercise testing (cpet) threshold values that distinguish disease severity progression in patients with co-existing systolic heart failure (Hf) and chronic obstructive pulmonary disease (COPD), and to evaluate the impact of the cut-off determined on the prognosis of hospitalizations. We evaluated 40 patients (30 men and 10 woman) with HF and copD through pulmonary function testing, doppler echocardiography and maximal incremental cpet on a cycle ergometer. Several significant CPET threshold values were identified in detecting a forced expiratory volume in 1 second (FEV 1 ) < 1.6 L: 1) oxygen uptake efficiency slope (OUES) < 1.3; and 2) circulatory power (cp) < 2383 mmHg.mlO 2 .kg −1 . CPET significant threshold values in identifying a left ventricular ejection fraction (LVef) < 39% were: 1) OUES: < 1.3; 2) CP < 2116 mmHg.mlO 2 .kg −1 . min −1 and minute ventilation/carbon dioxide production (V̇e/Vċo 2 ) slope>38. The 15 (38%) patients hospitalized during follow-up (8 ± 2 months). In the hospitalizations analysis, LVEF < 39% and FEV 1 < 1.6, OUES < 1.3, CP < 2116 mmHg.mlO 2 .kg −1 .min −1 and V̇e/Vċo 2 > 38 were a strong risk predictor for hospitalization (p ≤ 0.050). The CPET response effectively identified worsening disease severity in patients with a Hf-copD phenotype. LVef, feV 1, CP, OUES, and the V̇e/Vċo 2 slope may be particularly useful in the clinical assessment and strong risk predictor for hospitalization.

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Italian survey on prevalence and disease management of chronic heart failure and chronic obstructive pulmonary disease comorbidity in ambulatory patients. SUSPIRIUM study rationale and design

Cited by 4 publications

References 20 publications

Strength of association between comorbidities and asthma: a meta-analysis

Strength of association between comorbidities and asthma: a meta-analysis

Frequent coexistence of chronic heart failure and chronic obstructive pulmonary disease in respiratory and cardiac outpatients: Evidence from SUSPIRIUM, a multicentre Italian survey

The Value of Cardiopulmonary Exercise Testing in Determining Severity in Patients with both Systolic Heart Failure and COPD

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