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Observational Study
. 2019 Jan 16;19(1):20.
doi: 10.1186/s12872-018-0986-y.

Morbidity and mortality in a population of patients affected by heart failure and chronic obstructive pulmonary disease: an observational study

Eugenio Roberto Cosentino  1 , Matteo Landolfo  2 , Crescenzio Bentivenga  2 , Luca Spinardi  2 , Daniela Degli Esposti  2 , Arrigo Francesco Cicero  2 , Rinaldo Miceli  2 , Virna Bui  2 , Emanuela Berardi  3 , Claudio Borghi  2
Affiliations
Observational Study

Morbidity and mortality in a population of patients affected by heart failure and chronic obstructive pulmonary disease: an observational study

Eugenio Roberto Cosentino et al. BMC Cardiovasc Disord. .

Abstract

Background: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) often coexist. Moreover, elderly patients suffering from HF have a higher incidence of COPD, which further complicates their clinical condition. Indacaterol/glycopirronium has shown benefits in the treatment of COPD, with few cardiologic adverse effects. We evaluated the safety and efficacy of this therapy in patients with history of HF.

Methods: We enrolled 56 patients with a history of HF (New York Heart Association [NYHA] classes II and III) and stable COPD. We evaluated blood samples, clinical assessment, echocardiograms and basal spirometry at baseline and after 6 months of therapy with indacaterol/glycopirronium. In addition, the number of re-hospitalizations during the treatment period was evaluated.

Results: The treatment was well tolerated. Brain natriuretic peptide (BNP) levels were significantly reduced compared with baseline (p < 0.001) after 6 months of treatment, and a higher percentage of patients improved their clinical status compared with baseline (p < 0.001). Minor changes were noted in the hemodynamic and metabolic parameters. Significant improvements in the echocardiographic parameters were noted in HF with reduced ejection fraction (HFrEF) patients. All respiratory parameters (forced expiratory volume in 1 s [FEV1], FEV1/forced vital capacity [FVC] ratio and COPD Assessment Test [CAT] scores) improved significantly (p < 0.001). No hospitalizations owing to HF or COPD exacerbation occurred. One patient died of respiratory failure.

Conclusion: Indacaterol/glycopirronium was well-tolerated and effective in the treatment of COPD in this cohort of patients with a history of HF. Further studies are needed to clarify whether this compound can have a direct role in improving overall cardiovascular function.

Keywords: Chronic obstructive pulmonary disease; Elderly; Heart failure; Indacaterol/glycopirronium.

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Conflict of interest statement

Ethics approval and consent to participate

Yes. Informed, written consent was obtained from all participants. The study was evaluated by the ethical board of the S. Orsola-Malpighi University Hospital.

Consent for publication

Yes

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

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Fig. 1
Study design and patients’ enrolment
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