Diagnostic and Therapeutic Gaps in Patients With Heart Failure and Chronic Obstructive Pulmonary Disease

Marco Canepa*, Frits M. E. Franssen, Horst Olschewski, Mitja Lainscak, Michael Boehm, Luigi Tavazzi, Stephan Rosenkranz

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

35 Citations (Web of Science)

Abstract

Heart failure (HF) and chronic obstructive pulmonary disease (COPD) coincide in a significant number of patients. Recent population-based registries suggest that spirometry is largely underused in patients with HF to diagnose comorbid COPD and that patients with COPD frequently do not receive the recommended beta-blocker (BB) treatment. This state-of-the-art review summarizes: 1) current challenges in the implementation of recommended spirometry for COPD diagnosis in patients with HF; and 2) current underuse and underdosing of BBs in patients with HF and COPD despite guideline recommendations. Open issues in the therapeutic management of patients with HF and COPD are discussed in the third section, including the use of the nonselective BB carvedilol, target BB doses in patients with HF and COPD, BB and bronchodilator management during HF hospitalization with and without COPD exacerbation, and the use of BBs in patients with COPD with right HF or free from cardiovascular disease. The whole scenario described herein advocates for a bipartisan initiative to drive immediate attention to the translation of guideline recommendations into clinical practice for patients with HF with co-occurring COPD. (C) 2019 by the American College of Cardiology Foundation.

Original languageEnglish
Pages (from-to)823-833
Number of pages11
JournalJACC-Heart Failure
Volume7
Issue number10
DOIs
Publication statusPublished - Oct 2019

Keywords

  • ASSOCIATION
  • BETA-BLOCKERS
  • EUROPEAN-SOCIETY
  • EXACERBATIONS
  • IMPACT
  • LUNG-DISEASE
  • MORTALITY
  • OUTCOMES
  • RISK
  • SYSTOLIC DYSFUNCTION
  • airflow limitation
  • beta-blockers
  • chronic obstructive pulmonary disease
  • heart failure
  • spirometry
  • PROGNOSTIC IMPACT
  • 2013 ACCF/AHA GUIDELINE

Cite this