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Obstructive Ventilatory Disorder in Heart Failure—Caused by the Heart or the Lung?

  • Comorbidities of Heart Failure (C Angermann, Section Editor)
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Abstract

Heart failure (HF) is a clinical syndrome frequently associated with airway obstruction, either as a respiratory comorbidity or as a direct consequence of HF pathophysiology. Recognizing the relative contribution of an underlying airway disease as opposed to airway obstruction due to volume overload and left atrial pressure elevation is of importance for the appropriate management of patients affected by HF. This review focuses on “les liaisons dangereuses” between the heart and the lungs, outlying recent advances linking in a vicious circle of chronic obstructive lung disease (COPD) and obstructive sleep apnea (OSA) on one side and HF on the other side. It also discusses the role of pivotal diagnostic tools such as pulmonary function tests and cardiopulmonary exercise test to determine the contribution of HF and COPD to symptoms and clinical status. Treatment implications are discussed as well.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. •• Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, et al. 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016. These are the recently published ESC guidelines on HF.

  2. •• Güder G, Brenner S, Störk S, Hoes A, Rutten FH. Chronic obstructive pulmonary disease in heart failure: accurate diagnosis and treatment. Eur J Heart Fail. 2014;16:1273–82. This is a clinical review focusing on the assessment and treatment of COPD in patients with HF.

  3. •• Hawkins NM, Virani S, Ceconi C. Heart failure and chronic obstructive pulmonary disease: the challenges facing physicians and health services. Eur Heart J. 2013;34:2795–803. This is a clinical review illustrating the difficulties of differentiating COPD and HF in terms of diagnosis and management.

  4. Mentz RJ, Kelly JP, von Lueder TG, Voors AA, Lam CS, Cowie MR, et al. Noncardiac comorbidities in heart failure with reduced versus preserved ejection fraction. J Am Coll Cardiol. 2014;64:2281–93.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Hawkins NM, Wang D, Petrie MC, Pfeffer MA, Swedberg K, Granger CB, et al. Baseline characteristics and outcomes of patients with heart failure receiving bronchodilators in the CHARM Programme. Eur J Heart Fail. 2010;12:557–65.

    Article  PubMed  Google Scholar 

  6. Hawkins NM, Petrie MC, Macdonald MR, Jhund PS, Fabbri LM, Wikstrand J, et al. Heart failure and chronic obstructive pulmonary disease the quandary of beta-blockers and beta-agonists. J Am Coll Cardiol. 2011;57:2127–38.

    Article  CAS  PubMed  Google Scholar 

  7. Hope J. A treatise on the diseases of the heart and great vessels. 2nd ed. London: W Kidd; 1835.

    Google Scholar 

  8. Miller WL, Mullan BP. Volume overload profiles in patients with preserved (HFpEF) and reduced (HFrEF) ejection fraction chronic heart failure Are There differences? a pilot study. JACC Heart Fail. 2016;4:453–9.

    Article  PubMed  Google Scholar 

  9. Agostoni P, Cattadori G, Guazzi M, Palermo P, Bussotti M, Marenzi G. Cardiomegaly as a possible cause of lung dysfunction in patients with heart failure. Am Heart J. 2000;140:e24.

    Article  CAS  PubMed  Google Scholar 

  10. Chen Y, Guo H, Xu D, Xu X, Wang H, Hu X, et al. Left ventricular failure produces profound lung remodeling and pulmonary hypertension in mice: heart failure causes severe lung disease. Hypertension. 2012;59:1170–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Güder G, Rutten FH, Brenner S, Angermann CE, Berliner D, Ertl G, et al. The impact of heart failure on the classification of COPD severity. J Card Fail. 2012;18:637–44.

    Article  PubMed  Google Scholar 

  12. Baum C, Ojeda FM, Wild PS, Rzayeva N, Zeller T, Sinning CR, et al. Subclinical impairment of lung function is related to mild cardiac dysfunction and manifest heart failure in the general population. Int J Cardiol. 2016;218:298–304.

    Article  PubMed  Google Scholar 

  13. •• Brenner S, Güder G, Berliner D, Deubner N, Fröhlich K, Ertl G, et al. Airway obstruction in systolic heart failure—COPD or congestion? Int J Cardiol. 2013;168:1910–6. This is a post-hoc analysis from a prospective study, in which serial pulmonary function testing was done (both at discharge and 6 months after hospitalization for decompensation of HF).

  14. Cundrle Jr I, Johnson BD, Somers VK, Scott CG, Rea RF, Olson LJ. Effect of cardiac resynchronization therapy on pulmonary function in patients with heart failure. Am J Cardiol. 2013;112:838–42.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Al-Majed NS, Armstrong PW, Bakal JA, Hernandez AF, Ezekowitz JA. Correlation between peak expiratory flow rate and NT-proBNP in patients with acute heart failure. An analysis from ASCEND-HF trial. Int J Cardiol. 2015;182:184–6.

    Article  PubMed  Google Scholar 

  16. Sun XG, Hansen JE, Oudiz RJ, Wasserman K. Pulmonary function in primary pulmonary hypertension. J Am Coll Cardiol. 2003;41:1028–35.

    Article  PubMed  Google Scholar 

  17. Trip P, Nossent EJ, de Man FS, van den Berk IA, Boonstra A, Groepenhoff H, et al. Severely reduced diffusion capacity in idiopathic pulmonary arterial hypertension: patient characteristics and treatment responses. Eur Respir J. 2013;42:1575–85.

    Article  CAS  PubMed  Google Scholar 

  18. •• Galiè N, Humbert M, Vachiery JL, Gibbs S, Lang I, Torbicki A, et al. 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension: the joint task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J. 2016;37:67–119. These are the recent ESC/ERS Guidelines on PH.

  19. Peták F, Janosi TZ, Myers C, Fontao F, Habre W. Impact of elevated pulmonary blood flow and capillary pressure on lung responsiveness. J Appl Physiol. 2009;107:780–6.

    Article  PubMed  Google Scholar 

  20. West JB. Respiratory physiology: the essentials. 9th ed. Philadelphia: Lippincott Williams and Wilkins; 2011.

    Google Scholar 

  21. Borlaug BA, Nishimura RA, Sorajja P, Lam CS, Redfield MM. Exercise hemodynamics enhance diagnosis of early heart failure with preserved ejection fraction. Circ Heart Fail. 2010;3:588–95.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Ceridon ML, Morris NR, Olson TP, Lalande S, Johnson BD. Effect of supine posture on airway blood flow and pulmonary function in stable heart failure. Respir Physiol Neurobiol. 2011;178:269–74.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Wetzel RC, Herold CJ, Zerhouni EA, Robotham JL. Intravascular volume loading reversibly decreases airway cross-sectional area. Chest. 1993;103:865–70.

    Article  CAS  PubMed  Google Scholar 

  24. Wagner EM, Mitzner W. Effects of bronchial vascular engorgement on airway dimensions. J Appl Physiol (1985). 1996;81:293–301.

    CAS  Google Scholar 

  25. Ishii M, Matsumoto N, Fuyuki T, Hida W, Ichinose M, Inoue H, et al. Effects of hemodynamic edema formation on peripheral vs. central airway mechanics. J Appl Physiol (1985). 1985;59:1578–84.

    CAS  Google Scholar 

  26. Tanabe T, Kanoh S, Moskowitz WB, Rubin BK. Cardiac asthma: transforming growth factor-β from the failing heart leads to squamous metaplasia in human airway cells and in the murine lung. Chest. 2012;142:1274–83.

    Article  CAS  PubMed  Google Scholar 

  27. Cabanes LR, Weber SN, Matran R, Regnard J, Richard MO, Degeorges ME, et al. Bronchial hyperresponsiveness to methacholine in patients with impaired left ventricular function. N Engl J Med. 1989;320:1317–22.

    Article  CAS  PubMed  Google Scholar 

  28. Johnson BD, Beck KC, Olson LJ, O’Malley KA, Allison TG, Squires RW, et al. Pulmonary function in patients with reduced left ventricular function: influence of smoking and cardiac surgery. Chest. 2001;120:1869–76.

    Article  CAS  PubMed  Google Scholar 

  29. Jorge S, Becquemin MH, Delerme S, Bennaceur M, Isnard R, Achkar R, et al. Cardiac asthma in elderly patients: incidence, clinical presentation and outcome. BMC Cardiovasc Disord. 2007;7:16.

    Article  PubMed  PubMed Central  Google Scholar 

  30. • Lyons OD, Bradley TD. Heart failure and sleep apnea. Can J Cardiol. 2015;31:898–908. This is a contemporary review on the interrelationships between HF and sleep apnea.

  31. Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK, et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events. Deliberations of the sleep apnea definitions task force of the American Academy of Sleep Medicine. J Clin Sleep Med. 2012;8:597–619.

    PubMed  PubMed Central  Google Scholar 

  32. Roca GQ, Redline S, Claggett B, Bello N, Ballantyne CM, Solomon SD, et al. Sex-specific association of sleep apnea severity with subclinical myocardial injury, ventricular hypertrophy, and heart failure risk in a community-dwelling cohort: the atherosclerosis risk in communities-sleep heart health study. Circulation. 2015;132:1329–37.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Oldenburg O, Lamp B, Faber L, Teschler H, Horstkotte D, Töpfer V. Sleep-disordered breathing in patients with symptomatic heart failure: a contemporary study of prevalence in and characteristics of 700 patients. Eur J Heart Fail. 2007;9:251–7.

    Article  PubMed  Google Scholar 

  34. Herrscher TE, Akre H, Øverland B, Sandvik L, Westheim AS. High prevalence of sleep apnea in heart failure outpatients: even in patients with preserved systolic function. J Card Fail. 2011;17:420–5.

    Article  PubMed  Google Scholar 

  35. Arzt M, Woehrle H, Oldenburg O, Graml A, Suling A, Erdmann E, et al. Prevalence and predictors of sleep-disordered breathing in patients with stable chronic heart failure: the SchlaHF registry. JACC Heart Fail. 2016;4:116–2.

    Article  PubMed  Google Scholar 

  36. Yumino D, Redolfi S, Ruttanaumpawan P, Su MC, Smith S, Newton GE, et al. Nocturnal rostral fluid shift: a unifying concept for the pathogenesis of obstructive and central sleep apnea in men with heart failure. Circulation. 2010;121:1598–605.

    Article  PubMed  Google Scholar 

  37. Kasai T, Motwani SS, Elias RM, Gabriel JM, Taranto Montemurro L, Yanagisawa N, et al. Influence of rostral fluid shift on upper airway size and mucosal water content. J Clin Sleep Med. 2014;10:1069–74.

    PubMed  PubMed Central  Google Scholar 

  38. Basoglu OK, Keskin B, Tasbakan MS, Gurgun C. Effect of semirecumbent sleep position on severity of obstructive sleep apnea in patients with heart failure. J Card Fail. 2015;21:842–7.

    Article  PubMed  Google Scholar 

  39. Kasai T, Motwani SS, Yumino D, Mak S, Newton GE, Bradley TD. Differing relationship of nocturnal fluid shifts to sleep apnea in men and women with heart failure. Circ Heart Fail. 2012;5:467–74.

    Article  PubMed  Google Scholar 

  40. Iversen KK, Kjaergaard J, Akkan D, Kober L, Torp-Pedersen C, Hassager C, et al. The prognostic importance of lung function in patients admitted with heart failure. Eur J Heart Fail. 2010;12:685–91.

    Article  PubMed  Google Scholar 

  41. • Freixa X, Portillo K, Paré C, Garcia-Aymerich J, Gomez FP, Benet M, et al. Echocardiographic abnormalities in patients with COPD at their first hospital admission. Eur Respir J. 2013;41:784–91. This is a large collaborative work evaluating the type and prevalence of echocardiographic abnormalities in consecutive patients at their first hospitalization for exacerbation of COPD.

  42. Barr RG, Bluemke DA, Ahmed FS, Carr JJ, Enright PL, Hoffman EA, et al. Percent emphysema, airflow obstruction, and impaired left ventricular filling. N Engl J Med. 2010;362:217–27.

    Article  PubMed  PubMed Central  Google Scholar 

  43. • Smith BM, Prince MR, Hoffman EA, Bluemke DA, Liu CY, Rabinowitz D, et al. Impaired left ventricular filling in COPD and emphysema: is it the heart or the lungs? The Multi-Ethnic Study of Atherosclerosis COPD Study. Chest. 2013;144:1143–51. This is a collaborative work in support of underfilling of the left ventricle secondary to hyperinflation in patients with COPD.

  44. Kawut SM, Poor HD, Parikh MA, Hueper K, Smith BM, Bluemke DA, et al. Cor pulmonale parvus in chronic obstructive pulmonary disease and emphysema: the MESA COPD study. J Am Coll Cardiol. 2014;64:2000–9.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Portillo K, Torralba Y, Blanco I, Burgos F, Rodriguez-Roisin R, Rios J, et al. Pulmonary hemodynamic profile in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2015;10:1313–20.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Hilde JM, Skjørten I, Grøtta OJ, Hansteen V, Melsom MN, Hisdal J, et al. Right ventricular dysfunction and remodeling in chronic obstructive pulmonary disease without pulmonary hypertension. J Am Coll Cardiol. 2013;62:1103–11.

    Article  PubMed  Google Scholar 

  47. •• Seeger W, Adir Y, Barberà JA, Champion H, Coghlan JG, Cottin V, et al. Pulmonary hypertension in chronic lung diseases. J Am Coll Cardiol. 2013;62(25 Suppl):D109–16. This manuscript is part of the proceedings of the last World Symposium on PH, focusing on PH in patients with lung diseases.

  48. •• Vachiéry JL, Adir Y, Barberà JA, Champion H, Coghlan JG, Cottin V, et al. Pulmonary hypertension due to left heart diseases. J Am Coll Cardiol. 2013;62(25 Suppl):D100–8. This manuscript is part of the proceedings of the last World Symposium on PH, focusing on PH in patients with heart diseases.

  49. •• Rosenkranz S, Gibbs JS, Wachter R, De Marco T, Vonk-Noordegraaf A, Vachiéry JL. Left ventricular heart failure and pulmonary hypertension. Eur Heart J. 2016;37:942–54. This is a critical review on the complex pathophysiology of cardiopulmonary interaction in left heart disease and their implications for right ventricular failure.

  50. Gerges M, Gerges C, Pistritto AM, Lang MB, Trip P, Jakowitsch J, et al. Pulmonary hypertension in heart failure. Epidemiology, right ventricular function, and survival. Am J Respir Crit Care Med. 2015;192:1234–46.

    Article  PubMed  Google Scholar 

  51. Gottlieb DJ, Yenokyan G, Newman AB, O’Connor GT, Punjabi NM, Quan SF, et al. Prospective study of obstructive sleep apnea and incident coronary heart disease and heart failure: the sleep heart health study. Circulation. 2010;122:352–60.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Naeije R. Pulmonary hypertension in hypoventilation syndromes. Eur Respir J. 2014;43:12–5.

    Article  PubMed  Google Scholar 

  53. Parati G, Lombardi C, Castagna F, Mattaliano P, Filardi PP, Agostoni P, et al. Heart failure and sleep disorders. Nat Rev Cardiol. 2016;13:389–403.

    Article  CAS  PubMed  Google Scholar 

  54. Ismail K, Roberts K, Manning P, Manley C, Hill NS. OSA and pulmonary hypertension: time for a new look. Chest. 2015;147:847–61. doi:10.1378/chest.14-0614.

    Article  PubMed  Google Scholar 

  55. Koshino Y, Villarraga HR, Orban M, Bruce CJ, Pressman GS, Leinveber P, et al. Changes in left and right ventricular mechanics during the Mueller maneuver in healthy adults: a possible mechanism for abnormal cardiac function in patients with obstructive sleep apnea. Circ Cardiovasc Imaging. 2010;3:282–9.

    Article  PubMed  Google Scholar 

  56. Lisi E, Faini A, Bilo G, Lonati LM, Revera M, Salerno S, et al. Diastolic dysfunction in controlled hypertensive patients with mild-moderate obstructive sleep apnea. Int J Cardiol. 2015;187:686–92.

    Article  PubMed  Google Scholar 

  57. Pressman GS, Orban M, Leinveber P, Parekh K, Singh M, Kara T, et al. Effects of the Mueller maneuver on functional mitral regurgitation and implications for obstructive sleep apnea. Am J Cardiol. 2015;115:1563–7.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Colish J, Walker JR, Elmayergi N, Almutairi S, Alharbi F, Lytwyn M, et al. Obstructive sleep apnea: effects of continuous positive airway pressure on cardiac remodeling as assessed by cardiac biomarkers, echocardiography, and cardiac MRI. Chest. 2012;141:674–81.

    Article  PubMed  Google Scholar 

  59. Cadby G, McArdle N, Briffa T, Hillman DR, Simpson L, Knuiman M, et al. Severity of OSA is an independent predictor of incident atrial fibrillation hospitalization in a large sleep-clinic cohort. Chest. 2015;148:945–52.

    Article  PubMed  Google Scholar 

  60. Sørensen HT, Horvath-Puho E, Lash TL, Christiansen CF, Pesavento R, Pedersen L, et al. Heart disease may be a risk factor for pulmonary embolism without peripheral deep venous thrombosis. Circulation. 2011;124:1435–41.

    Article  PubMed  Google Scholar 

  61. Piazza G, Goldhaber SZ. Pulmonary embolism in heart failure. Circulation. 2008;118:1598–601.

    Article  PubMed  Google Scholar 

  62. Mor A, Thomsen RW, Ulrichsen SP, Sørensen HT. Chronic heart failure and risk of hospitalization with pneumonia: a population-based study. Eur J Intern Med. 2013;24:349–53.

    Article  PubMed  Google Scholar 

  63. Maisel A, Neath SX, Landsberg J, Mueller C, Nowak RM, Peacock WF, et al. Use of procalcitonin for the diagnosis of pneumonia in patients presenting with a chief complaint of dyspnoea: results from the BACH (Biomarkers in Acute Heart Failure) trial. Eur J Heart Fail. 2012;14:278–86.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Guazzi M, Adams V, Conraads V, Halle M, Mezzani A, Vanhees L, et al. EACPR/AHA Joint Scientific Statement. Clinical recommendations for cardiopulmonary exercise testing data assessment in specific patient populations. Eur Heart J. 2012;33:2917–27.

    Article  PubMed  Google Scholar 

  65. • Guazzi M, Arena R, Halle M, Piepoli MF, Myers J, Lavie CJ. 2016 focused update: clinical recommendations for cardiopulmonary exercise testing data assessment in specific patient populations. Eur Heart J. 2016. [Epub ahead of print]. These are the update recommendations on cardiopulmonary exercise testing in specific patient populations, including HF and COPD.

  66. Poon CS, Tin C. Mechanism of augmented exercise hyperpnea in chronic heart failure and dead space loading. Respir Physiol Neurobiol. 2013;186:114–30.

    Article  PubMed  Google Scholar 

  67. • Neder JA, Arbex FF, Alencar MC, O’Donnell CD, Cory J, Webb KA, et al. Exercise ventilatory inefficiency in mild to end-stage COPD. Eur Respir J. 2015;45:377–87. This is a work describing ventilatory behavior during exercise according to disease severity in a large, contemporary COPD population.

  68. Elbehairy AF, Ciavaglia CE, Webb KA, Guenette JA, Jensen D, Mourad SM, et al. Pulmonary gas exchange abnormalities in mild chronic obstructive pulmonary disease. Implications for dyspnea and exercise intolerance. Am J Respir Crit Care Med. 2015;191:1384–94.

    Article  PubMed  Google Scholar 

  69. Olson TP, Johnson BD. Influence of cardiomegaly on disordered breathing during exercise in chronic heart failure. Eur J Heart Fail. 2011;13:311–8.

    Article  PubMed  Google Scholar 

  70. Ciarka A, Vachièry JL, Houssière A, Gujic M, Stoupel E, Velez-Roa S, et al. Atrial septostomy decreases sympathetic overactivity in pulmonary arterial hypertension. Chest. 2007;131:1831–7.

    Article  PubMed  Google Scholar 

  71. Lewis GD, Shah RV, Pappagianopolas PP, Systrom DM, Semigran MJ. Determinants of ventilatory efficiency in heart failure: the role of right ventricular performance and pulmonary vascular tone. Circ Heart Fail. 2008;1:227–33.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Malfatto G, Caravita S, Giglio A, Rossi J, Perego GB, Facchini M, et al. Pulmonary congestion at rest and abnormal ventilation during exercise in chronic systolic heart failure. J Am Heart Assoc. 2015;4(5).

  73. Gargiulo P, Apostolo A, Perrone-Filardi P, Sciomer S, Palange P, Agostoni P. A non invasive estimate of dead space ventilation from exercise measurements. PLoS One. 2014;9(1):e87395.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Boerrigter BG, Bogaard HJ, Trip P, Groepenhoff H, Rietema H, Holverda S, et al. Ventilatory and cardiocirculatory exercise profiles in COPD: the role of pulmonary hypertension. Chest. 2012;142:1166–74.

    Article  PubMed  Google Scholar 

  75. Vicenzi M, Deboeck G, Faoro V, Loison J, Vachiery JL, Naeije R. Exercise oscillatory ventilation in heart failure and in pulmonary arterial hypertension. Int J Cardiol. 2016;202:736–40.

    Article  PubMed  Google Scholar 

  76. Caravita S, Di Marco GM, Deboeck G, Novelli L, Vachiéry JL. The diastolic pressure gradient and the cardiorespiratory profile during exercise in pulmonary hypertension due to left heart disease. ESC Congress; 2015. p. abstract P5523.

  77. Cross TJ, Sabapathy S, Beck KC, Morris NR, Johnson BD. The resistive and elastic work of breathing during exercise in patients with chronic heart failure. Eur Respir J. 2012;39:1449–57.

    Article  PubMed  Google Scholar 

  78. Laveneziana P, Humbert M, Godinas L, Joureau B, Malrin R, Straus C, et al. Inspiratory muscle function, dynamic hyperinflation and exertional dyspnoea in pulmonary arterial hypertension. Eur Respir J. 2015;45:1495–8.

    Article  PubMed  Google Scholar 

  79. Mentz RJ, Fiuzat M, Kraft M, Lindenfeld J, O’Connor CM. Bronchodilators in heart failure patients with COPD: is it time for a clinical trial? J Card Fail. 2012;18:413–22.

    Article  CAS  PubMed  Google Scholar 

  80. Loth DW, Brusselle GG, Lahousse L, Hofman A, Leufkens HG, Stricker BH. β-adrenoceptor blockers and pulmonary function in the general population: the Rotterdam study. Br J Clin Pharmacol. 2014;77:190–200.

    Article  CAS  PubMed  Google Scholar 

  81. Contini M, Apostolo A, Cattadori G, Paolillo S, Iorio A, Bertella E, et al. Multiparametric comparison of CARvedilol, vs. NEbivolol, vs. BIsoprolol in moderate heart failure: the CARNEBI trial. Int J Cardiol. 2013;168:2134–40.

    Article  PubMed  Google Scholar 

  82. Agostoni P, Contini M, Cattadori G, Apostolo A, Sciomer S, Bussotti M, et al. Lung function with carvedilol and bisoprolol in chronic heart failure: is beta selectivity relevant? Eur J Heart Fail. 2007;9:827–33.

    Article  CAS  PubMed  Google Scholar 

  83. Bhatt SP, Wells JM, Kinney GL, Washko Jr GR, Budoff M, Kim YI, et al. β-Blockers are associated with a reduction in COPD exacerbations. Thorax. 2016;71:8–14.

    Article  PubMed  Google Scholar 

  84. Stefan MS, Rothberg MB, Priya A, Pekow PS, Au DH, Lindenauer PK. Association between β-blocker therapy and outcomes in patients hospitalised with acute exacerbations of chronic obstructive lung disease with underlying ischaemic heart disease, heart failure or hypertension. Thorax. 2012;67:977–84.

    Article  PubMed  PubMed Central  Google Scholar 

  85. Gershon A, Croxford R, Calzavara A, To T, Stanbrook MB, Upshur R, et al. Cardiovascular safety of inhaled long-acting bronchodilators in individuals with chronic obstructive pulmonary disease. JAMA Intern Med. 2013;173:1175–85.

    Article  PubMed  Google Scholar 

  86. Singer AJ, Emerman C, Char DM, Heywood JT, Kirk JD, Hollander JE, et al. Bronchodilator therapy in acute decompensated heart failure patients without a history of chronic obstructive pulmonary disease. Ann Emerg Med. 2008;51:25e34.

    Article  Google Scholar 

  87. Fu M, Zhou J, Thunström E, Almgren T, Grote L, Bollano E, et al. Optimizing the management of heart failure with preserved ejection fraction in the elderly by targeting comorbidities (OPTIMIZE-HFPEF). J Card Fail. 2016. doi:10.1016/j.cardfail.2016.01.011 [Epub ahead of print].

  88. Sun H, Shi J, Li M, Chen X. Impact of continuous positive airway pressure treatment on left ventricular ejection fraction in patients with obstructive sleep apnea: a meta-analysis of randomized controlled trials. PLoS One. 2013;8(5):e62298.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  89. Bucca CB, Brussino L, Battisti A, Mutani R, Rolla G, Mangiardi L, et al. Diuretics in obstructive sleep apnea with diastolic heart failure. Chest. 2007;132:440–6.

    Article  PubMed  Google Scholar 

  90. Lyons OD, Chan CT, Yadollahi A, Bradley TD. Effect of ultrafiltration on sleep apnea and sleep structure in patients with end-stage renal disease. Am J Respir Crit Care Med. 2015;191:1287–94.

    Article  PubMed  Google Scholar 

  91. Mendelson M, Lyons OD, Yadollahi A, Inami T, Oh P, Bradley TD. Effects of exercise training on sleep apnoea in patients with coronary artery disease: a randomised trial. Eur Respir J. 2016 Apr 13. pii: ERJ-01897-2015. doi: 10.1183/13993003.01897-2015. [Epub ahead of print]

  92. Rolla G, Bucca C, Brussino L, Gallo W, Malara D. Bronchodilating effect of ipratropium bromide in heart failure. Eur Respir J. 1993;6:1492–5.

    CAS  PubMed  Google Scholar 

  93. Light RW, George RB. Serial pulmonary function in patients with acute heart failure. Arch Intern Med. 1983;143:429–33.

    Article  CAS  PubMed  Google Scholar 

  94. Hoeper MM, Meyer K, Rademacher J, Fuge J, Welte T, Olsson KM. Diffusion capacity and mortality in patients with pulmonary hypertension Due to heart failure with preserved ejection fraction. JACC Heart Fail. 2016;4:441–9.

    Article  PubMed  Google Scholar 

  95. Petermann W, Barth J, Entzian P. Heart failure and airway obstruction. Int J Cardiol. 1987;17(2):207–9.

    Article  CAS  PubMed  Google Scholar 

  96. Olson TP, Johnson BD, Borlaug BA. Impaired pulmonary diffusion in heart failure with preserved ejection fraction. JACC Heart Fail. 2016;4:490–8.

    Article  PubMed  Google Scholar 

  97. Jabbour A, Macdonald PS, Keogh AM, Kotlyar E, Mellemkjaer S, Coleman CF, et al. Differences between beta-blockers in patients with chronic heart failure and chronic obstructive pulmonary disease: a randomized crossover trial. J Am Coll Cardiol. 2010;55:1780–7.

    Article  PubMed  Google Scholar 

  98. Düngen HD, Apostolovic S, Inkrot S, CIBIS-ELD investigators and Project Multicentre Trials in the Competence Network Heart Failure, et al. Titration to target dose of bisoprolol vs. carvedilol in elderly patients with heart failure: the CIBIS-ELD trial. Eur J Heart Fail. 2011;13:670–80.

    Article  PubMed  PubMed Central  Google Scholar 

  99. Lainscak M, Podbregar M, Kovacic D, Rozman J, von Haehling S. Differences between bisoprolol and carvedilol in patients with chronic heart failure and chronic obstructive pulmonary disease: a randomized trial. Respir Med. 2011;105:S44–9.

    Article  PubMed  Google Scholar 

  100. Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Am J Respir Crit Care Med. 2001;163:1256–76.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiovascular, Neural and Metabolic Sciences, S. Luca Hospital, Istituto Auxologico Italiano, IRCCS, Milan, Italy

    Sergio Caravita

  2. Pulmonary Hypertension and Heart Failure Clinic, Department of Cardiology, Cliniques Universitaires de Bruxelles, Hôpital Académique Erasme, Brussels, Belgium

    Sergio Caravita & Jean-Luc Vachiéry

  3. Department of Cardiology, CUB Hôpital Erasme, 808 Route de Lennik, 1070, Brussels, Belgium

    Jean-Luc Vachiéry

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Correspondence to Jean-Luc Vachiéry.

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Sergio Caravita and Jean-Luc Vachiéry declare that they have no conflict of interest

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This article is part of the Topical Collection on Comorbidities of Heart Failure

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Caravita, S., Vachiéry, JL. Obstructive Ventilatory Disorder in Heart Failure—Caused by the Heart or the Lung?. Curr Heart Fail Rep 13, 310–318 (2016). https://doi.org/10.1007/s11897-016-0309-5

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