TY - JOUR
T1 - The interplay between symptom deterioration of chronic obstructive pulmonary disease and chronic heart failure
AU - van Dijk, Sanne H.B.
AU - Brusse-Keizer, Marjolein G.J.
AU - Effing, Tanja
AU - Ploumen, Eline H.
AU - van der Valk, Paul D.L.P.M.
AU - van der Palen, Job
AU - Doggen, Carine J.M.
AU - Lenferink, Anke
PY - 2025/11
Y1 - 2025/11
N2 - Background: Chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) commonly co-exist and share symptoms, which complicates disease management. It is unclear how COPD and CHF deterioration inter(re)act. Objective: This study aimed to assess the interplay between COPD and CHF deterioration on group and individual level. Methods: Total daily COPD- and CHF-symptom intensity scores (SIS) were calculated based on increased symptoms of COPD (dyspnea, sputum purulence and color, coughing, wheezing, fever) and CHF (sudden weight increase, swelling, nocturnal dyspnea), as reported by patients in one-year daily symptom diaries. The COPD-CHF interplay was assessed visually and statistically (on group and individual level) by mixed models. Results: From a multicenter trial (N = 201), 33 patients with COPD and CHF (72.4 ± 7.8 years, 24 men (72.7 %)) were included. On group level, increased CHF-SIS positively predicted next day's COPD-SIS (p = 0.02). However, on individual level, the direction and strength of the associations between CHF-SIS and subsequent COPD-SIS varied substantially. Vice versa, increased COPD-SIS also predicted next day's CHF-SIS on group level (p < 0.001). On individual level, the direction of the associations varied less, although strength differed from negligible to strongly positive. Conclusions: On group level, CHF deterioration predicts an increase in next day's COPD symptom score, as well as vice versa. Individual-level associations reinforce the group-level results for COPD provoking CHF symptoms, but not for CHF provoking COPD symptoms. The COPD-CHF interplay should be monitored and, if present, acted upon to optimize patient disease management.
AB - Background: Chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) commonly co-exist and share symptoms, which complicates disease management. It is unclear how COPD and CHF deterioration inter(re)act. Objective: This study aimed to assess the interplay between COPD and CHF deterioration on group and individual level. Methods: Total daily COPD- and CHF-symptom intensity scores (SIS) were calculated based on increased symptoms of COPD (dyspnea, sputum purulence and color, coughing, wheezing, fever) and CHF (sudden weight increase, swelling, nocturnal dyspnea), as reported by patients in one-year daily symptom diaries. The COPD-CHF interplay was assessed visually and statistically (on group and individual level) by mixed models. Results: From a multicenter trial (N = 201), 33 patients with COPD and CHF (72.4 ± 7.8 years, 24 men (72.7 %)) were included. On group level, increased CHF-SIS positively predicted next day's COPD-SIS (p = 0.02). However, on individual level, the direction and strength of the associations between CHF-SIS and subsequent COPD-SIS varied substantially. Vice versa, increased COPD-SIS also predicted next day's CHF-SIS on group level (p < 0.001). On individual level, the direction of the associations varied less, although strength differed from negligible to strongly positive. Conclusions: On group level, CHF deterioration predicts an increase in next day's COPD symptom score, as well as vice versa. Individual-level associations reinforce the group-level results for COPD provoking CHF symptoms, but not for CHF provoking COPD symptoms. The COPD-CHF interplay should be monitored and, if present, acted upon to optimize patient disease management.
KW - Chronic heart failure
KW - Comorbidity
KW - COPD
KW - Exacerbation
KW - Intensive longitudinal data
KW - Interplay
KW - Symptoms
UR - http://www.scopus.com/inward/record.url?scp=105008972246&partnerID=8YFLogxK
U2 - 10.1016/j.hrtlng.2025.06.004
DO - 10.1016/j.hrtlng.2025.06.004
M3 - Article
AN - SCOPUS:105008972246
SN - 0147-9563
VL - 74
SP - 57
EP - 64
JO - Heart and Lung
JF - Heart and Lung
ER -