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Applying the Rome Proposal on Exacerbations of Chronic Obstructive Pulmonary Disease: Does Comorbid Chronic Heart Failure Matter?
Linköping University, Sweden.
RISE Research Institutes of Sweden, Digital Systems, Prototyping Society. Linköping University, Sweden.ORCID iD: 0000-0001-5702-7720
Linköping University, Sweden.
2023 (English)In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 18, p. 2055-2064Article in journal (Refereed) Published
Abstract [en]

Background: 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. Methods: 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. Results: 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. Conclusion: 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.

Place, publisher, year, edition, pages
Dove Medical Press Ltd , 2023. Vol. 18, p. 2055-2064
Keywords [en]
Chronic Disease; Comorbidity; Dyspnea; Heart Failure; Humans; Pulmonary Disease, Chronic Obstructive; Rome; C reactive protein; oxygen; arterial gas; Article; blood oxygen tension; body mass; breathing rate; chronic obstructive lung disease; comorbidity; data analysis; disease exacerbation; disease severity; dyspnea; forced expiratory volume; forced vital capacity; heart failure; heart left ventricle ejection fraction; heart rate; human; major clinical study; New York Heart Association class; physical activity; rest; self monitoring; spirometry; symptom; chronic disease; chronic obstructive lung disease; comorbidity; dyspnea; heart failure; Italy
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:ri:diva-67675DOI: 10.2147/COPD.S425592Scopus ID: 2-s2.0-85172425495OAI: oai:DiVA.org:ri-67675DiVA, id: diva2:1815856
Note

This work was supported by grants to P.K.J. and H.L.P from the Medical Research Council of Southeast Sweden (FORSS) (Grant No. FORSS-969385, FORSS-980999) and grants to L.L. and H.L.P. from Sweden’s innovation agency Vinnova (Dnr: 2019-05402) in Swelife’s and Medtech4Health’s Collaborative projects for better health programme.

Available from: 2023-11-30 Created: 2023-11-30 Last updated: 2023-12-05Bibliographically approved

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