Targeting occult heart failure in intensive care unit patients with acute chronic obstructive pulmonary disease exacerbation: effect on outcome and quality of life.
PURPOSE
To estimate the prevalence of previously undiagnosed heart failure in mechanically ventilated patients with severe exacerbation of chronic obstructive pulmonary disease (COPD) and to evaluate the impact of specific heart failure treatment on patients' outcome.


MATERIALS AND METHODS
In this prospective study, we included 107 consecutive patients with COPD without known history of cardiac disease who were admitted to the intensive care unit (ICU) because of hypercapnic respiratory failure leading to mechanical ventilation.


RESULTS
Patients were divided into 4 groups according to the echocardiographic findings: patients with isolated right or left ventricular failure, biventricular failure, and normal heart function. Three of 4 patients demonstrated findings of heart failure. In 41%, the presence of previously unrecognized left ventricular dysfunction was revealed. Patients with isolated left ventricular dysfunction experienced less days on mechanical ventilation, less intensive care unit days, improved quality of life, and decreased in-hospital and 6-month mortality compared with patients with normal heart.


CONCLUSIONS
In mechanically ventilated patients with severe exacerbation of COPD, unrecognized left or right ventricular failure is common. Among patients with isolated left ventricular failure, the early detection and appropriate treatment improves long-term quality of life and may decrease the short- and 6-month morbidity and mortality.
['Matamis|Dimitrios|D|', 'Tsagourias|Mathew|M|', 'Papathanasiou|Athanasios|A|', 'Sineffaki|Helen|H|', 'Lepida|Dimitra|D|', 'Galiatsou|Eytychia|E|', 'Nakos|George|G|']
D000368:Aged D018450:Disease Progression D005260:Female D006333:Heart Failure D006801:Humans D007362:Intensive Care Units D008297:Male D008875:Middle Aged D011446:Prospective Studies D029424:Pulmonary Disease, Chronic Obstructive D011788:Quality of Life D012121:Respiration, Artificial D018487:Ventricular Dysfunction, Left D018497:Ventricular Dysfunction, Right
Heart failure Chronic obstructive pulmonary disease Mechanical ventilation Echocardiogaphic examination