Detailed cardiovascular screening of COPD patients referred for rehabilitation identified previously undiagnosed heart failure in 9% of patients, mostly with preserved ejection fraction.
What is the prevalence of known and undiagnosed cardiovascular conditions in patients with COPD referred for rehabilitation?
Detailed cardiovascular screening in COPD patients entering rehabilitation reveals a high prevalence of undiagnosed heart failure and other cardiovascular conditions.
Absolute Event Rate: 0% vs 0%
OBJECTIVE: COPD is associated with cardiovascular (CV) conditions, largely through shared risk factors and pathophysiology. For patients undergoing rehabilitation, CV profile is relevant for risk stratification and individual program tailoring. With limited data in the literature, we performed CV screening in patients referred for rehabilitation. METHODS: Detailed CV history, clinical investigation, echocardiography, electrocardiogram (ECG) and NT-proBNP were assessed in patients starting the rehabilitation between 2012 and 2014. Odds ratio (OR) for CV condition was assessed in multiple logistic regression analysis including age, sex, hypercholesterolemia (HCE), arterial hypertension (AH) and GOLD stage. RESULTS: Overall, 90 patients (66±8 years, 68% men, 84% GOLD III/IV) were analyzed. Known history of AH, ischemic heart disease, atrial fibrillation and HCE was present in 49%, 10%, 5% and 25% of patients, respectively. At least one CV condition was known in 19% and at least three in 1% of patients. Heart failure was known in 16% while additional 9% met European Society of Cardiology heart failure diagnosis criteria, mostly with preserved left ventricular ejection fraction. ECG heart rate was 86±15 beats/min; any ECG abnormality was observed in 21% of patients, with repolarization abnormalities (8%), widened QRS (7%) and right bundle branch block (6%) being most prevalent findings. NT-proBNP level >125 ng/l was recorded in 52%. Age (OR=1.18, p=0.006) and HCE (OR=30.27, p<0.001) was associated with significantly higher OR for CV conditions. CONCLUSIONS: CV conditions are prevalent in patients with COPD referred for rehabilitation. Detailed assessment increased the prevalence of heart failure.
Omersa et al. (Mon,) reported a other. Detailed cardiovascular screening of COPD patients referred for rehabilitation identified previously undiagnosed heart failure in 9% of patients, mostly with preserved ejection fraction.