Dimitrios Matamis1, Mathew Tsagourias1, Athanasios Papathanasiou2, Helen Sineffaki3, Dimitra Lepida4, Eytychia Galiatsou5, George Nakos6. 1. Intensive Care Unit, Papageorgiou General Hospital, Thessaloniki, Greece. Electronic address: dmatamis@gmail.com. 2. Intensive Care Unit, University Hospital of Ioannina, Ioannina, Greece. Electronic address: thanasis.papathanasiou@gmail.com. 3. Intensive Care Unit, Papageorgiou General Hospital, Thessaloniki, Greece. Electronic address: thanasis.papathanasiou@gmail.com. 4. Intensive Care Unit, University Hospital of Ioannina, Ioannina, Greece. Electronic address: demylepida@yahoo.gr. 5. Intensive Care Unit, University Hospital of Ioannina, Ioannina, Greece. Electronic address: efiegaliatsou@gmail.com. 6. Intensive Care Unit, University Hospital of Ioannina, Ioannina, Greece. Electronic address: gnakos@cc.uoi.gr.
Abstract
PURPOSE: To estimate the prevalence of previously undiagnosed heart failure in mechanically ventilated patients with severe exacerbation of chronic obstructive pulmonary disease (COPD) and to evaluate the impact of specific heart failure treatment on patients' outcome. MATERIALS AND METHODS: In this prospective study, we included 107 consecutive patients with COPD without known history of cardiac disease who were admitted to the intensive care unit (ICU) because of hypercapnic respiratory failure leading to mechanical ventilation. RESULTS: Patients were divided into 4 groups according to the echocardiographic findings: patients with isolated right or left ventricular failure, biventricular failure, and normal heart function. Three of 4 patients demonstrated findings of heart failure. In 41%, the presence of previously unrecognized left ventricular dysfunction was revealed. Patients with isolated left ventricular dysfunction experienced less days on mechanical ventilation, less intensive care unit days, improved quality of life, and decreased in-hospital and 6-month mortality compared with patients with normal heart. CONCLUSIONS: In mechanically ventilated patients with severe exacerbation of COPD, unrecognized left or right ventricular failure is common. Among patients with isolated left ventricular failure, the early detection and appropriate treatment improves long-term quality of life and may decrease the short- and 6-month morbidity and mortality.
PURPOSE: To estimate the prevalence of previously undiagnosed heart failure in mechanically ventilated patients with severe exacerbation of chronic obstructive pulmonary disease (COPD) and to evaluate the impact of specific heart failure treatment on patients' outcome. MATERIALS AND METHODS: In this prospective study, we included 107 consecutive patients with COPD without known history of cardiac disease who were admitted to the intensive care unit (ICU) because of hypercapnic respiratory failure leading to mechanical ventilation. RESULTS:Patients were divided into 4 groups according to the echocardiographic findings: patients with isolated right or left ventricular failure, biventricular failure, and normal heart function. Three of 4 patients demonstrated findings of heart failure. In 41%, the presence of previously unrecognized left ventricular dysfunction was revealed. Patients with isolated left ventricular dysfunction experienced less days on mechanical ventilation, less intensive care unit days, improved quality of life, and decreased in-hospital and 6-month mortality compared with patients with normal heart. CONCLUSIONS: In mechanically ventilated patients with severe exacerbation of COPD, unrecognized left or right ventricular failure is common. Among patients with isolated left ventricular failure, the early detection and appropriate treatment improves long-term quality of life and may decrease the short- and 6-month morbidity and mortality.
Authors: Jesús Recio Iglesias; Jesús Díez-Manglano; Francisco López García; José Antonio Díaz Peromingo; Pere Almagro; José Manuel Varela Aguilar Journal: Int J Chron Obstruct Pulmon Dis Date: 2020-05-07