Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Department of Respiratory Medicine in Linköping, Linköping University, Linköping, Sweden.
Int J Chron Obstruct Pulmon Dis. 2023 Sep 19;18:2055-2064. doi: 10.2147/COPD.S425592. eCollection 2023.
Chronic heart failure (CHF) is a common comorbidity among patients with chronic obstructive pulmonary disease (COPD). Both exacerbations of COPD (ECOPDs) and exacerbations of CHF (ECHFs) display worsening of breathlessness at rest (BaR) and breathlessness at physical activity (BaPA). Comorbid CHF may have an impact on the vital signs assessed, when the Rome proposal (adopted by GOLD 2023) is applied on ECOPDs. Thus, the aim of the present study was to investigate the impact of comorbid CHF on ECOPDs severity, particularly focusing on the influence of comorbid CHF on BaR and BaPA.
We analysed data on COPD symptoms collected from the telehealth study The eHealth Diary. Patients with COPD (n = 43) and patients with CHF (n = 41) were asked to daily monitor BaR and BaPA, employing a digital pen and scales for BaR and BaPA (from 0 to 10). Twenty-eight patients of the COPD patients presented with comorbid CHF. Totally, 125 exacerbations were analysed.
Exacerbations in the group with COPD patients and comorbid CHF were compared to the group with COPD patients without comorbid CHF and the group with CHF patients. Compared with GOLD 2022, the GOLD 2023 (the Rome proposal) significantly downgraded the ECOPD severity. Comorbid CHF did not interfere significantly on the observed difference. Comorbid CHF did not worsen BaR scores, assessed at inclusion and at the symptom peak of the exacerbations.
In the present study, we find no evidence that comorbid CHF would interfere significantly with the parameters included in the Rome proposal (GOLD 2023). We conclude that the Rome proposal can be safely applied even on COPD patients with very advanced comorbid CHF.
慢性心力衰竭（CHF）是慢性阻塞性肺疾病（COPD）患者常见的合并症。COPD 加重（ECOPD）和 CHF 加重（ECHF）都会导致静息时呼吸困难（BaR）和活动时呼吸困难（BaPA）恶化。当 Rome 提案（被 GOLD 2023 采纳）应用于 ECOPD 时，合并 CHF 可能会影响评估的生命体征。因此，本研究旨在探讨合并 CHF 对 ECOPD 严重程度的影响，特别是关注合并 CHF 对 BaR 和 BaPA 的影响。
我们分析了远程医疗研究“电子健康日记”中收集的 COPD 症状数据。COPD 患者（n=43）和 CHF 患者（n=41）每天都被要求用数字笔和 BaR、BaPA 量表（从 0 到 10）监测 BaR 和 BaPA。43 名 COPD 患者中有 28 名患有合并 CHF。共分析了 125 次加重。
将合并 CHF 的 COPD 患者组与无合并 CHF 的 COPD 患者组和 CHF 患者组进行比较。与 GOLD 2022 相比，GOLD 2023（Rome 提案）显著降低了 ECOPD 严重程度。合并 CHF 对观察到的差异没有显著影响。合并 CHF 并没有使加重时的 BaR 评分恶化，包括纳入时和症状高峰时的 BaR 评分。
在本研究中，我们没有发现证据表明合并 CHF 会显著干扰 Rome 提案（GOLD 2023）中包含的参数。我们得出结论，即使是患有严重合并 CHF 的 COPD 患者，也可以安全地应用 Rome 提案。
