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Tuberc Respir Dis > Accepted Articles
DOI: https://doi.org/10.4046/trd.2020.0088    [Accepted]
Published online October 13, 2020.
Implications of managing Chronic Obstructive Pulmonary Disease (COPD) in Cardiovascular Diseases
Kartik Deshmukh, 1, Arjun Khanna, 2
1Fuqua School of Business, Duke University, Durham, North Carolina
2Department of Pulmonary Medicine, Yashoda Hospital, Delhi
Correspondence:  Kartik Deshmukh,
Email: Kartik.deshmukh@duke.edu/ Deshmukh.kartik333@gmail.com
Received: 29 July 2020   • Revised: 31 August 2020   • Accepted: 13 October 2020
Abstract
Globally, cardiovascular diseases and Chronic Obstructive Pulmonary Disease (COPD) are the leading causes of non-communicable disease burden. Over-lapping symptoms such as breathlessness and fatigue, coupled with a lack of awareness about COPD among physicians, are important reasons for under-diagnosis and resultant sub-optimal care in COPD. Much has been published earlier on the pathogenesis and implications of cardiovascular comorbidities in COPD. However, a comprehensive review of prevalence and the impact of COPD management in commonly encountered cardiac diseases is lacking. This study aimed at summarizing the current knowledge regarding the prevalence of COPD in heart failure, ischemic heart disease, and atrial fibrillation. We have also discussed the real-life clinical presentation and practical implications of managing COPD in cardiac diseases. We searched Pubmed, Scopus, EMBASE, and Google Scholar for studies published between 1981 to May 2020 reporting the prevalence of COPD in the three specified cardiac diseases. COPD has a high prevalence in heart failure, atrial fibrillation, and ischemic heart disease. Despite this, COPD remains under-diagnosed and under-managed in the majority of patients with cardiac diseases. Clinical implications of the diagnosis of COPD in cardiac disease includes recognition of hyperinflation (a treatable trait), implementation of AECOPD prevention strategies, and reducing the risk of overuse of diuretics. Pharmacological agents for the management of COPD have shown a beneficial effect on cardiac functions and mortality. Appropriate management of COPD improves the cardiovascular outcomes by reducing hyperinflation and preventing AECOPD, thereby reducing the risk of mortality, improving exercise tolerance, and quality of life.
Key Words: COPD, Heart Failure, Atrial Fibrillation, Ischemic Heart Disease, Hyperinflation, Cardiovascular diseases, Spirometry, COPD-CVD


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