The interplay between COPD and chronic heart failure deterioration

Background: COPD and chronic heart failure (CHF) commonly co-exist and share symptoms, which complicates disease management. It is unclear how symptom deterioration of COPD and CHF inter(re)act.

Aim: Assess the interplay between COPD and CHF deterioration at group and individual level.

Methods: Total daily COPD (0-7) and CHF (0-6) symptom scores, based on increased symptoms reported in 1-year daily diaries (ERJ 2019 54:1802134), were used to assess the COPD-CHF interplay at group and individual level using two mixed models.

Results: 33 patients (72±8 years, 24 men (73%)) were included.

Model 1 shows that, at group level, increased CHF symptom score predicts next day’s COPD symptoms (p=0.02). This was not consistently observed at individual level due to the large variation in the direction and strength of the individual-level associations (Fig 1A).

Model 2 shows that, at group level, increased COPD symptom score predicts next day’s CHF symptoms (p<0.001). Less variation was observed in the direction of the model 2 individual-level associations, still, they differed in strength from no association to strong positive associations (Fig 1B).

Conclusions: At group level, CHF deterioration predicts an increase in next day’s COPD symptom score as well as vice versa. Yet, at individual level, only the group-level conclusion of model 2 holds. Increased COPD symptoms thus consistently predict deterioration of CHF the next day within individual patients.