Dr Hasan Hafizur Rahman, Assistant Professor, Department of Medicine, Sheikh Hasina Medical College, Tangail, Bangladesh; E-mail:
Mymensingh Med J. 2022 Apr;31(2):498-505.
Heart failure and chronic obstructive pulmonary disease (COPD) are acquiring significant morbidity and mortality and the amalgamation presents many diagnostic challenges. Assessment of cardiac and pulmonary function by echocardiography and pulmonary function tests should be executed in all patients with cautious explanation to avoid misdiagnosis and wrong treatment. Both conditions share overlapping pathophysiological processes. Both functional status and quality of life are greatly influenced by these and associated with high morbidity and mortality rates leading to increase the health-care costs. Although both diseases have been studied extensively, information about the correlation between heart failure and COPD is lacking. Classifying the reason of breathing symptoms among people with both the diseases can be demanding. Therefore it is plausible that a considerable proportion of patients with a diagnosis of COPD have associated heart failure, which ruins unrecognized by primary care physicians or pulmonologists. This study's aim was to assess the relationship between chronic obstructive pulmonary disease and heart failure among elderly patients with chronic cough and dyspnea. This study was done in 100 patient's ≥40 years with a GP (general physician) diagnosis of COPD. Descriptive cross sectional study was carried out in the Department of Medicine, Shaheed Ziaur Rahman Medical College Hospital, Bogra, Bangladesh from November 2011 to April 2012. A total of 100 cases of chronic cough with breathlessness coming into out patient department and admitted into Department of Medicine of Shaheed Ziaur Rahman Medical College Hospital, Bogra, Bangladesh were included according to inclusion and exclusion criteria. Informed written consent was taken from the participants and data was collected by a questionnaire and relevant investigations were done. Data were analyzed with SPSS software and were expressed as mean±SE and significance level of differences among the group was calculated by unpaired student's 't' test. In this study among 100 participating patients with a diagnosis of COPD by their physician, in 24(24%) patients had previously unrecognized heart failure. Pearson Correlation study showed that there is significant positive correlation between FEV₁/FVC and Left Ventricular Diastolic Dysfunction and there is also significant positive correlation between FEV₁/FVC and Total Left Ventricular Dysfunction. By this study we recommend that evaluation and assessment of cardiac status is very important in elderly patients with COPD.
心力衰竭和慢性阻塞性肺疾病(COPD)正在导致显著的发病率和死亡率,并且这两种疾病的合并症带来了许多诊断挑战。所有患者都应该通过超声心动图和肺功能测试来评估心功能和肺功能,并谨慎解释结果,以避免误诊和错误治疗。这两种疾病具有重叠的病理生理过程。功能状态和生活质量都受到很大影响,并且与高发病率和死亡率相关,从而增加了医疗保健成本。尽管这两种疾病已经得到了广泛的研究,但关于心力衰竭和 COPD 之间相关性的信息仍然缺乏。在同时患有这两种疾病的人群中,区分呼吸症状的原因可能具有挑战性。因此,相当一部分被诊断为 COPD 的患者可能患有相关的心力衰竭,但这并未被初级保健医生或肺病学家识别。本研究旨在评估老年慢性咳嗽和呼吸困难患者中 COPD 和心力衰竭之间的关系。这项研究是在孟加拉国博格拉的谢赫·齐亚乌尔·拉赫曼医学院医院内科进行的,共纳入了 100 名年龄≥40 岁、经全科医生(GP)诊断为 COPD 的患者。这是一项描述性的横断面研究,于 2011 年 11 月至 2012 年 4 月在孟加拉国博格拉的谢赫·齐亚乌尔·拉赫曼医学院医院内科进行。根据纳入和排除标准,共纳入了 100 例因慢性咳嗽和呼吸困难就诊于门诊并收入博格拉谢赫·齐亚乌尔·拉赫曼医学院医院内科的患者。向参与者征求了知情书面同意,并通过问卷收集了数据,并进行了相关检查。使用 SPSS 软件分析数据,结果表示为平均值±SE,组间差异的显著性水平通过非配对学生 t 检验进行计算。在这项研究中,在 100 名被医生诊断为 COPD 的患者中,有 24 名(24%)患者此前未被识别出患有心力衰竭。Pearson 相关性研究表明,FEV₁/FVC 与左心室舒张功能障碍之间存在显著的正相关,FEV₁/FVC 与总左心室功能障碍之间也存在显著的正相关。通过这项研究,我们建议对 COPD 老年患者进行心脏状态的评估和检查非常重要。