Right Heart Failure as a Risk Factor for Severe Exacerbation in Patients with Chronic Obstructive Pulmonary Disease: Prospective Cohort Study.

Background The prognosis in patients with Chronic Obstructive Pulmonary Disease (COPD) depends, in large part, on the frequency of exacerbations. Cardiovascular diseases, including heart failure (HF), are the risk factors for exacerbations. However, the importance of HF type over the exacerbations in COPD patients is unknown. Objective To determine whether right heart failure (RHF) is an independent risk factor for severe exacerbations in patients with COPD. Methods A prospective cohort study of 133 patients diagnosed with COPD with a follow-up period from 2010 to 2016. Patients with bronchial hyperreactivity, asthma, or pulmonary embolism were excluded. Results The mean age was 74.7 +/- 8.2 years and 43.6% were men, 69.9% had severe exacerbations during follow-up. Subjects with RHF had lower FEV1 (50.2 +/- 19.9 vs 57.4 +/- 16.9, P = .006) and greater incidence of stroke (15.4% vs 1.8%, P = .009) compared to those without RHF. Subjects with RHF were at higher risk of severe exacerbations (HR, 2.46; CI 95%, 1.32-4.58, P = .005) compared to those without RHF after adjusting for confounding variables. Conclusion In patients with COPD, RHF is an independent risk factor for suffering severe exacerbations.