Breathlessness, but not cough, suggests chronic obstructive pulmonary disease in elderly smokers with stable heart failure
Breathlessness, but not cough, suggests chronic obstructive pulmonary disease in elderly smokers with stable heart failure
Authors
Enrico M. Clini
Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Respiratory Diseases, University of Modena and Reggio Emilia, Modena, Italy
Sara Roversi
Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena
Bianca Beghè
Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena; Department of Respiratory Diseases, University of Modena and Reggio Emilia, Modena
Michela Schito
Department of Medical Sciences, University of Ferrara, Ferrara
Martina Garofalo
Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena; Department of Respiratory Diseases, University of Modena and Reggio Emilia, Modena
Mariarita Stendardo
Department of Medical Sciences, University of Ferrara, Ferrara
Valentina Ruggieri
Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena
Roberto Tonelli
Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena; Department of Respiratory Diseases, University of Modena and Reggio Emilia, Modena
Alessandro Fucili
Department of Cardiology, and LTTA Centre, University-Hospital of Ferrara, Ferrara
Roberto D’Amico
Statistic Unit, Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena
Federico Banchelli
Statistic Unit, Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena
Leonardo M. Fabbri
Department of Respiratory Diseases, University of Modena and Reggio Emilia, Modena; Sahlgresnska University-Hospital, Gothenburg
Chronic obstructive pulmonary disease (COPD) is a common comorbidity of heart failure (HF), but remains often undiagnosed, and we aimed to identify symptoms predicting COPD in HF. As part of an observational, prospective study, we investigated stable smokers with a confirmed diagnosis of HF, using the 8-item COPD-Assessment-Test (CAT) questionnaire to assess symptoms. All the items were correlated with the presence of COPD, and logistic regression models were used to identify independent predictors. 96 HF patients were included, aged 74, 33% with COPD. Patients with HF and COPD were more symptomatic, but only breathlessness when walking up a hill was an independent predictor of COPD (odds ratio = 1.33, p = 0.0484). Interestingly, COPD-specific symptoms such as cough and phlegm were not significant. Thus, in elderly smokers with stable HF, significant breathlessness when walking up a hill is most indicative of associated COPD, and may indicate the need for further lung function evaluation.
