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Unrecognized heart failure common in elderly

Heart failure goes unrecognized in about 1 in 5 elderly patients with stable chronic obstructive pulmonary disease (COPD), Dutch researchers report. "Closer co-operation between general practitioners, pulmonologists, and cardiologists is necessary to optimize management of this large population of patients," they say.

In a cross-sectional study published in the September issue of the European Heart Journal, Dr. Frans H. Rutten and colleagues from University Medical Center Utrecht, the Netherlands, examined the prevalence of unrecognized heart failure among patients at least 65 years of age with COPD and no known history of heart failure.

A total of 405 patients underwent an extensive diagnostic work-up that included medical history, physical examination, chest radiography, electrocardiography, echocardiography, and pulmonary function tests.

The consensus opinion of an expert panel was used as the reference or "gold" standard. Among the 405 COPD patients, 83 (20.5%) were found to have previously unrecognized heart failure. Of these, 42 (50.6%) had systolic heart failure and 41 (49.4%) had isolated diastolic heart failure. None of the patients had right-sided heart failure.