HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Falk, J. A. Articles by Diaz, P. Search for Related Content PubMed PubMed Citation Articles by Falk, J. A. Articles by Diaz, P.

Cardiac Disease in Chronic Obstructive Pulmonary Disease

¹ Division of Pulmonary and Critical Care Medicine, Department of Medicine, Cedars-Sinai Medical Center, for the David Geffen School of Medicine at UCLA, Los Angeles, California; ² Division of Pulmonary and Critical Care, Ohio State University Medical Center, Columbus, Ohio; ³ Division of Pulmonary and Critical Care Medicine, Temple Lung Center, Temple University School of Medicine, Philadelphia, Pennsylvania; ⁴ University of Maryland School of Medicine, Baltimore, Maryland; and ⁵ Department of Pulmonary, Allergy, and Critical Care Medicine, Cleveland Clinic, Cleveland, Ohio

Correspondence and requests for reprints should be addressed to Jeremy A. Falk, M.D., 8700 Beverly Boulevard, Room 6732, Los Angeles, CA 90048. E-mail: falkja{at}cshs.org

ABSTRACT

The cardiac manifestations of chronic obstructive pulmonary disease (COPD) are numerous. Impairments of right ventricular dysfunction and pulmonary vascular disease are well known to complicate the clinical course of COPD and correlate inversely with survival. The pathogenesis of pulmonary vascular disease in COPD is likely multifactorial and related to alterations in gas exchange and vascular biology, as well as structural changes of the pulmonary vasculature and mechanical factors. Several modalities currently exist for the assessment of pulmonary vascular disease in COPD, but right heart catheterization remains the gold standard. Although no specific therapy other than oxygen has been generally accepted for the treatment of pulmonary hypertension in this population, there has been renewed interest in specific pulmonary vasodilators. The coexistence of COPD and coronary artery disease occurs frequently. This association is likely related to shared risk factors as well as similar pathogenic mechanisms, such as systemic inflammation. Management strategies for the care of patients with COPD and coronary artery disease are similar to those without COPD, but care must be given to address their respiratory limitations. Arrhythmias occur frequently in patients with COPD, but are rarely fatal and can generally be treated medically. Use of β-blockers in the management of cardiac disease, while a theoretical concern in patients with increased airway resistance, is generally safe with the use of cardioselective agents.

Key Words: emphysema • pulmonary hypertension • cor pulmonale • coronary artery disease

This article has been cited by other articles:

				S. Janda, K. Park, J. M. FitzGerald, M. Etminan, and J. Swiston Statins in COPD: A Systematic Review Chest, September 1, 2009; 136(3): 734 - 743. [Abstract] [Full Text] [PDF]

				M. W. Sims, D. J. Margolis, A. R. Localio, R. A. Panettieri, S. M. Kawut, and J. D. Christie Impact of Pulmonary Artery Pressure on Exercise Function in Severe COPD Chest, August 1, 2009; 136(2): 412 - 419. [Abstract] [Full Text] [PDF]

				F. Luppi, F. Franco, B. Beghe, and L. M. Fabbri Treatment of Chronic Obstructive Pulmonary Disease and Its Comorbidities Proceedings of the ATS, December 1, 2008; 5(8): 848 - 856. [Abstract] [Full Text] [PDF]

				G. Calmettes, V. Deschodt-Arsac, E. Thiaudiere, B. Muller, and P. Diolez Modular control analysis of effects of chronic hypoxia on mouse heart Am J Physiol Regulatory Integrative Comp Physiol, December 1, 2008; 295(6): R1891 - R1897. [Abstract] [Full Text] [PDF]