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Impact of Chronic Obstructive Pulmonary Disease in Heart Failure With Preserved Ejection Fraction.

MedStar author(s):

0002-9149

Name of journal: The American journal of cardiologyAbstract: 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 (n=48), HFpEF alone (n=79) and HFpEF+COPD (n=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 HFpEF+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; p=0.003), a greater LV mass (67.4, 95%CI: 60.7-74.2; p=0.03, and LV extracellular volume (49.4, 95%CI: 40.9-57.9; p=0.002). Patients with comorbid HFpEF+COPD also exhibited greater thoracic aortic stiffness assessed by pulse-wave velocity (11.3, 95% CI: 8.7-14.0 m/s; p=0.004) and pulsatile load imposed by the ascending aorta as measured by aortic characteristic impedance (139 dsc; 95%CI=111-166; p=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. Copyright (c) 2021. Published by Elsevier Inc.All authors: Akers S, Chirinos J, Gade KC, Gadela NV, Hashmath Z, Jain S, Kondaveety S, Kulick-Soper CM, Kulkarni V, Lee J, Obeid MJ, Paravathaneni M, Sanchez N, Satija V, Singh G, Yenigalla S, Zamani POriginally published: American Journal of Cardiology. 2021 Mar 21Fiscal year: FY2021Digital Object Identifier:

https://dx.doi.org/10.1016/j.amjcard.2021.03.009

Date added to catalog: 2021-06-07

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Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	33757785	Available		33757785

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 (n=48), HFpEF alone (n=79) and HFpEF+COPD (n=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 HFpEF+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; p=0.003), a greater LV mass (67.4, 95%CI: 60.7-74.2; p=0.03, and LV extracellular volume (49.4, 95%CI: 40.9-57.9; p=0.002). Patients with comorbid HFpEF+COPD also exhibited greater thoracic aortic stiffness assessed by pulse-wave velocity (11.3, 95% CI: 8.7-14.0 m/s; p=0.004) and pulsatile load imposed by the ascending aorta as measured by aortic characteristic impedance (139 dsc; 95%CI=111-166; p=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. Copyright (c) 2021. Published by Elsevier Inc.

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