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• W2155125418 abstract "We read the article “Airway obstruction in systolic heart failure (SHF) — Chronic obstructive pulmonary disease (COPD) or congestion?” by Susanne Brenner et al. with interest [1]. The authors aimed to estimate the prevalence, correlates and prognostic impact of true COPD in patients with SHF. They concluded that COPD is over-diagnosed in SHF. Also, COPD has a pronounced impact on survival only when proven by pulmonary function testing (PFT) under stable conditions. Chronic obstructive pulmonary disease and heart failure are prevalent comorbidities affecting a huge proportion of the world population, responsible for significantmorbidity andmortality [2]. COPD is a cluster of heterogenic disorders, characterized by expiratory flow limitation that is not completely reversible and in most cases progressive. A clinical diagnosis of COPD should be considered in any patient who has dyspnea, chronic coughor sputumproductionandhistoryof exposureof risk factors such as smoking. Spirometry is only one parameter for establishing the clinical diagnosis of COPD [3]. In the presented study [1], about half of the patients (45.6%) in the study population had never smoked. Similarly, the rate of never-smokers in patients with diagnosis of COPD was 28%. And there is no information on the presence of other risk factors. Since COPD is characterizedbyfixedairflowobstruction, thismay lead tomisdiagnosisof various diseases with fixed airflow obstruction such as tuberculosis, bronchiectasis and lung cancer [4]. For these reasons, in patients (28%) without any risk factors may had received the wrong diagnosis. At this point, radiological images are important for the differential diagnosis. Another reason for the continuation of fixed airway obstruction in patients with no history of exposure to risk factors may be the continuation of decompensated left heart failure. Although they found that the mean ejection fraction of patients with proven COPD was 41% [1], population-based studies show that approximately half of all patients with heart failure have preserved left ventricular systolic function (HF-PEF) [5]. So, the continuation of fixed airwayobstructionmaybe associatedwith not only SHF but alsoHF-PEF. Finally, we think that further studies will mention these factors in patients with airway obstruction." @default.
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• W2155125418 date "2013-10-01" @default.
• W2155125418 modified "2023-10-16" @default.
• W2155125418 title "Further studies on diastolic dysfunction in patients with airway obstruction should be kept in mind" @default.
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• W2155125418 doi "https://doi.org/10.1016/j.ijcard.2013.04.014" @default.
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