Journal article
Impact of Chronic Obstructive Pulmonary Disease in Heart Failure With Preserved Ejection Fraction
The American journal of cardiology, Vol.149, pp.47-56
06/15/2021
DOI: 10.1016/j.amjcard.2021.03.009
PMID: 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 (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.
Details
- Title: Subtitle
- Impact of Chronic Obstructive Pulmonary Disease in Heart Failure With Preserved Ejection Fraction
- Creators
- Snigdha Jain - Yale UniversityMary Jo Obeid - Duke Medical CenterSowjanya Yenigalla - University of ArizonaMahati Paravathaneni - Catholic Medical CenterNaga Vaishnavi Gadela - UConn HealthGurpreet Singh - Rowan UniversityVarsha Kulkarni - University of PennsylvaniaSoumya Kondaveety - MedStar HealthKeerthi Chandrika Gade - University of PennsylvaniaJonathan Lee - Palo Alto UniversityColin M. Kulick-Soper - Rowan UniversityNicolas Sanchez - New York Medical CollegeVaibhav Satija - Saint Vincent HospitalZeba Hashmath - Saint Vincent HospitalPayman Zamani - Hospital of the University of PennsylvaniaScott Akers - Philadelphia VA Medical CenterJulio A. Chirinos - University of Pennsylvania
- Resource Type
- Journal article
- Publication Details
- The American journal of cardiology, Vol.149, pp.47-56
- DOI
- 10.1016/j.amjcard.2021.03.009
- PMID
- 33757785
- ISSN
- 0002-9149
- eISSN
- 1879-1913
- Publisher
- Elsevier Inc
- Number of pages
- 10
- Grant note
- R01-HL 121510; R33-HL-146390; R01HL153646; R01-AG058969; 1R01-HL104106; P01-HL094307; R03-HL146874; R56-HL136730 / NIH
- Language
- English
- Date published
- 06/15/2021
- Academic Unit
- Internal Medicine
- Record Identifier
- 9985221244502771
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