The Coexistence of Chronic Obstructive Pulmonary Disease and Heart Failure

Abstract

Chronic obstructive pulmonary disease (COPD) is a chronic illness that is widely prevalent within the United States and has been frequently associated with heart failure (HF). COPD is associated with progressive damage and inflammation of the airways leading to airflow obstruction and inadequate gas exchange. HF represents a decline in the normal functioning of the heart resulting in insufficient pumping of blood through the circulatory system. COPD and HF present with similar signs and symptoms with some variation. There are many specific diagnostic tests and treatment modalities which we use to diagnose COPD and HF, but it becomes an issue when you come across a patient who has both conditions simultaneously. For example, attempting to use an X-ray to diagnose HF in a COPD patient is next to impossible because the results are manipulated by the COPD disease process. This is the case with many other diagnostic tests such as an electrocardiogram (ECG), chest radiography (X-ray), B-type natriuretic peptide (BNP), echocardiogram, cardiac magnetic resonance imaging (CMR), pulmonary function test (PFT), arterial blood gas (ABG), and exercise stress testing. When a patient has both COPD and HF, it becomes more difficult to treat. Many treatments for HF have negative impacts on COPD patients and vice-versa, whereas some have also shown positive clinical outcomes in both diseases. It is agreeable that treatment has to be patient-centered and it can vary from case to case depending on the severity of the disease. Ultimately, in this review, we discuss COPD and HF and how they interplay in their diagnostic and treatment modalities to gain a better understanding of how to effectively manage patients who have been diagnosed with both conditions.

Predictive nomogram models for atrial fibrillation in COPD patients: A comprehensive analysis of risk factors and prognosis

“…Research has found that inflammatory reactions are closely related to pathological processes such as electrical remodeling, structural remodeling and autonomic nervous system remodeling (33,34). COPD patients experience increased pulmonary vascular resistance due to the positive end-expiratory pressure, which leads to the invasion of the interventricular septum into the left ventricle, impairing left ventricular filling and resulting in elevated left atrial and pulmonary vein pressures (35). This process of left atrial remodeling is particularly pronounced in COPD patients with comorbidities such as AF (36).…”

Analysis of pathogenesis and drug treatment of chronic obstructive pulmonary disease complicated with cardiovascular disease

“…On the other hand, the use of diuretics can reduce pulmonary congestion and edema, increase lung compliance and improve pulmonary ventilation function (119,120), which is beneficial for COPD patients. However, the related side effects caused by diuretics still need attention, such as hypokalemia, hypercapnia, metabolic alkalosis, and decreased cardiac output (121)(122)(123). Secondly, the excessive dosage of diuretics can lead to thick airway secretions in patients with COPD, thus making it difficult to expectoration and aggravating the disease.…”

Evaluating the Health-Related Quality of Life in Patients with COPD and Chronic Heart Failure Post-Hospitalization after COVID-19 Using the EQ-5D and KCCQ Questionnaires

“…Chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) are two prevalent conditions that significantly impact global health [ 1 , 2 ]. Both diseases are associated with high morbidity and mortality rates and lead to substantial degradation in the quality of life of affected individuals [ 3 , 4 , 5 ].…”