Chronic obstructive pulmonary disease (COPD) is an independent risk factor for cardiovascular disease (CVD) including heart failure (HF) and coronary arteries diseases, which are one of the leading causes of morbidity and mortality in COPD patients. Thus, COPD could deteriorate HF and explain the worst prognostic of the association of the two diseases. Actually, there is no information about the real prevalence of COPD assessed by systematic pulmonary function test in HF patients.

Describe the prevalence of COPD in a systolic HF population.

COPD was systematically researched by pulmonary function test in 274 patients (216 men) followed for systolic HF in the University’s Hospital of Rangueil, Toulouse, France between April 2002 and April 2009. Degrees of COPD were defined according to the GOLD classification.

In the 274 systolic HF patients mean age was 61 ± 11 years and mean ejection fraction (EF) was 32 ± 15% with 130 (47%) patients with ischemic systolic HF. There was 112 (41%) of COPD with 57 (20.8%), 44 (16.1%), 7 (2.6%) and 4 (1.5%) GOLD 1, 2, 3 and 4 respectively. There was not difference between no-COPD and COPD groups in sex (77.7 vs 75.9% men; p = 0.1) and NYHA stage (mean 2.2 ± 0.7 vs 2.3 ± 0.8; p = 0.3) but patients with COPD were older (66.1 ± 11 vs 57.1 ± 13.7 years; p<0.001) and had better EF (33.5 ± 9.4 vs 30.2 ± 12.9%; p = 0.016). There was 43.8% ischemic heart failure in the COPD group versus 51.8% in the no-COPD group (p = 0.13) and no-COPD group had a tendency to have more β-blocker treatment (74.1 vs 62.5%; p = 0.051).

COPD has a high prevalence in systolic HF population but clinical diagnostic is difficult because of the lack of specificity of dyspnoea assessed by NYHA stage. HF patients with COPD are older and have a better EF suggesting that dyspnoea from pulmonary disease is interpreted as a symptom of HF.