Unrecognized Heart Failure and Chronic Obstructive Pulmonary Disease (COPD) in Frail Elderly Detected Through a Near-Home Targeted Screening Strategy

Abstract

Background: Reduced exercise tolerance and dyspnea are common in older people, and heart failure (HF) and chronic obstructive pulmonary disease (COPD) are the main causes. We want to determine the prevalence of previously unrecognized HF, COPD, and other chronic diseases in frail older people using a nearhome targeted screening strategy.Methods: Community-dwelling frail persons aged >65 years underwent a 2-step screening strategy. First, they received a questionnaire inquiring about dyspnea and exercise tolerance. Those with exercise intolerance and/or dyspnea were invited to visit their primary care physician's office for a screening program, including medical history taking, physical examination, blood tests, electrocardiography, spirometry, and echocardiography. The final diagnosis of every patient was determined by a panel consisting of 3 physicians.

Mid‐regional pro‐atrial natriuretic peptide for the early detection of non‐acute heart failure

“…Biomarkers, in particular natriuretic peptides, have been studied in great depth over the years to improve diagnostic accuracy. NT‐proBNP has already been shown to be of great value to general practitioners and to clinicians in outpatient clinics to help with selection of individuals from the community with suggestive HF symptoms who require echocardiography . With our study we provide evidence that this also holds true for MR‐proANP.…”

“…The importance of early diagnosis cannot be reiterated enough as early initiation of treatment can prevent or slow down progression, positively effect quality of life and reduce the risk of mortality . HF continues to remain underdiagnosed, especially in older individuals in the community . One reason for this is that the diagnosis of HF can be challenging, as the symptoms shaping the syndrome of HF often overlap with other conditions.…”

Survival and spirometry outcomes after lung transplantation from donors aged 70 years and older

“…This risk increases with donor age because the spontaneous incidence of obstructive lung disease exponentially increases with age. 28 Donor lung function testing is seldom available in cadaveric donation, and respiratory parameters under mechanical ventilation barely reflect how the lung will perform in the recipient. Interestingly, our data indicate that an obstructive lung function pattern is more frequently seen after transplant in recipients with IPF than in recipients with emphysema as the underlying disease.…”

Opportunistic screening for heart failure with natriuretic peptides in patients with atrial fibrillation: a meta-analysis of individual participant data of four screening studies

“…In case of disagreement, the final diagnosis was made by the majority vote. Reproducibility of the panel diagnosis was evaluated by reassessment of a random sample of 10% of diagnosis and showed high kappa values (range 0.7420 to 0.928). …”