Chronic Obstructive Pulmonary Disease and Heart Failure: Closer than Close

Kronična opstruktivna plućna bolest i zatajenje srca: tako blizu, a tako daleko

Sestre Milosrdnice University hospital and Institute of Clinical Medical Research 2017

Chronic obstructive pulmonary disease (COPD) and heart failure (HF) both are global epidemics with substantial burden on morbidity and mortality. They present major challenges to healthcare providers and often coexsist. Multiple interactions exist between these conditions. COPD is often responsible for delayed diagnosis of HF and vice versa, since both conditions have similar symptoms such as dyspnea and poor exercise tolerance based on the skeletal myopathic response rather than the primary organ failure. Patients with COPD also have an increased risk of developing HF and higher hospitalization and death rates compared with HF patients without COPD. Echocardiography and pulmonary function tests along with natriuretic peptides should be performed and carefully interpreted. Diagnostic assessment of both conditions present in the same patient is often difficult, but therapeutic approach is also often non-adherent to current guidelines. For example, patients with coexisting COPD and HF receive beta-blockers at disappointingly low rates below 20%. Closer collaboration between cardiologists and pulmonologists is required for better identification and management of concurrent COPD and HF.
Kronična opstruktivna plućna bolest (KOPB) i zatajenje srca među vodećim su uzrocima pobolijevanja i smrtnosti u svijetu. Unatoč brojnim poveznicama, kod bolesnika s kroničnom opstruktivnom plućnom bolešću zatajenje srca ostaje često neprepoznato, no vrijedi i obratno. Kod bolesnika s prethodno utvrđenom KOPB dijagnoza zatajenja srca se često postavlja prekasno, no vrijedi i obratno, ponajviše zbog vrlo sličnih simptoma i znakova bolesti poput zaduhe i intolerancije napora uslijed disfunkcije skeletne muskulature. Bolesnici s KOPB-om imaju viši rizik zatajenja srca, ali i češće hospitalizacije i smrtnost od bolesnika sa zatajenjem srca bez pridružene KOPB. Ehokardiografija, testovi plućne funkcije i određivanje natriuretskih peptida trebaju biti neizostavni dio dijagnostičkog postupka i reevaluacije bolesnika uz bližu suradnju subspecijalista kardiologa i pulmologa sa svrhom ne samo pouzdane dijagnoze, već i optimalnog pristupa liječenju bolesnika s često prisutnim komorbiditetima.

Pulmonary disease, chronic obstructive – diagnosis; Pulmonary disease, chronic obstructive – therapy; Heart failure – diagnosis; Echocardiography; Respiratory function tests; Plućna bolest, kronična opstruktivna – dijagnostika; Plućna bolest, kronična opstruktivna – terapija; Srčano zatajivanje – dijagnostika; Ehokardiografija; Respiracija, ispitivanje funkcije; text; info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion

Open access content. Open access content
info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-nd/4.0

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