Impact of Chronic Obstructive Pulmonary Disease in Heart Failure With Preserved Ejection Fraction.
Am J Cardiol
; 149: 47-56, 2021 06 15.
Article
em En
| MEDLINE
| ID: mdl-33757785
ABSTRACT
COPD often coexists with HFpEF, but its impact on cardiovascular structure and function in HFpEF is incompletely understood. We aimed to compare cardiovascular phenotypes in patients with Chronic Obstructive Pulmonary Disease (COPD), Heart Failure with Preserved Ejection Fraction (HFpEF), or both. We studied 159 subjects with COPD alone (nâ¯=â¯48), HFpEF alone (nâ¯=â¯79) and HFpEFâ¯+â¯COPD (nâ¯=â¯32). We used MRI and arterial tonometry to assess cardiac structure and function, thoracic aortic stiffness, and measures of body composition. Relative to participants with COPD only, those with HFpEF with or without COPD exhibited a greater prevalence of female sex and obesity, whereas those with HFpEFâ¯+â¯COPD were more often African-American. Compared to the other groups, participants with HFpEF and COPD demonstrated a more concentric LV geometry (LV wall-cavity ratio 1.2, 95%CI 1.1-1.3; pâ¯=â¯0.003), a greater LV mass (67.4, 95%CI 60.7-74.2; pâ¯=â¯0.03, and LV extracellular volume (49.4, 95%CI 40.9-57.9; pâ¯=â¯0.002). Patients with comorbid HFpEFâ¯+â¯COPD also exhibited greater thoracic aortic stiffness assessed by pulse-wave velocity (11.3, 95% CI 8.7-14.0 m/s; pâ¯=â¯0.004) and pulsatile load imposed by the ascending aorta as measured by aortic characteristic impedance (139 dsc; 95%CI=111-166; pâ¯=â¯0.005). Participants with HFpEF, with or without COPD, exhibited greater abdominal and pericardial fat, without difference in thoracic skeletal muscle size. In conclusion, individuals with co-morbid HFpEF and COPD have a greater degree of systemic large artery stiffening, LV remodeling, and LV fibrosis than those with either condition alone.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Composição Corporal
/
Remodelação Ventricular
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Doença Pulmonar Obstrutiva Crônica
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Rigidez Vascular
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Insuficiência Cardíaca
/
Ventrículos do Coração
/
Obesidade
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Am J Cardiol
Ano de publicação:
2021
Tipo de documento:
Article