Chronic heart failure and risk of hospitalization with pneumonia: A population-based study

Mor, Anil; Thomsen, Reimar Wernich; Ulrichsen, Sinna Pilgaard; Sørensen, Henrik Toft

doi:10.1016/j.ejim.2013.02.013

Cited by 46 publications

(35 citation statements)

References 30 publications

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“…In contrast to earlier studies, we also took into account other clinically relevant confounding variables: pneumonia, hyperglycemia, and renal failure. Patients with chronic heart failure have a markedly increased risk of pneumonia, 15 and pneumonia can precipitate and worsen HF. 16 Patients with higher blood glucose level, even in the absence of diabetes, have an increased risk of HF.…”

Section: Discussionmentioning

confidence: 99%

Decompensated Heart Failure Is a Strong Independent Predictor of Functional Outcome After Ischemic Stroke

Burkot

Kopeć

Pera

et al. 2015

Journal of Cardiac Failure

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Section: Discussionmentioning

confidence: 99%

Decompensated Heart Failure Is a Strong Independent Predictor of Functional Outcome After Ischemic Stroke

Burkot

Kopeć

Pera

et al. 2015

Journal of Cardiac Failure

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“…25,27 Comorbidities considered prevalent at baseline were defined using the same approach. We included those that have been associated with pneumonia in uninfected populations, namely congestive heart failure (CHF) 22,23,28 and other cardiovascular diseases, 29 chronic renal and liver disease, 30,31 diabetes mellitus, 23,32 malignancy 30 and as well as hepatitis C infection (HCV). Prior pneumonia diagnoses were also defined by ICD-9 codes.…”

Section: Methodsmentioning

confidence: 99%

Association of COPD With Risk for Pulmonary Infections Requiring Hospitalization in HIV-Infected Veterans

Attia

McGinnis

Feemster

et al. 2015

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background Pulmonary infections remain more common in HIV-infected (HIV+) compared to uninfected individuals. The increase in chronic lung diseases among aging HIV+ individuals may contribute to this persistent risk. We sought to determine whether chronic obstructive pulmonary disease (COPD) is an independent risk factor for different pulmonary infections requiring hospitalization among HIV+ patients. Methods We analyzed data from 41,993 HIV+ Veterans in the nationwide Veterans Aging Cohort Study Virtual Cohort (VACS-VC) from 1996–2009. Using ICD-9 codes, we identified baseline comorbid conditions, including COPD, and incident community-acquired pneumonia (CAP), pulmonary tuberculosis (TB) and Pneumocystis jirovecii pneumonia (PCP) requiring hospitalization within two years after baseline. We used multivariable Poisson regression to determine incidence rate ratios (IRR) associated with COPD for each type of pulmonary infection, adjusting for comorbidities, CD4+ cell count, HIV viral load, smoking status, substance use, vaccinations and calendar year at baseline. Results Unadjusted incidence rates of CAP, TB and PCP requiring hospitalization were significantly higher among persons with COPD compared to those without COPD (CAP: 53.9 vs. 19.4 per 1,000 person-years; TB: 8.7 vs. 2.8; PCP: 15.5 vs. 9.2; p ≤0.001). In multivariable Poisson regression models, COPD was independently associated with increased risk of CAP, TB and PCP (IRR 1.94, 95% CI 1.64–2.30; IRR 2.60, 95% CI 1.70–3.97; and IRR 1.48, 95% CI 1.10–2.01, respectively). Conclusions COPD is an independent risk factor for CAP, TB and PCP requiring hospitalization among HIV+ individuals. As the HIV+ population ages, the growing burden of COPD may confer substantial risk for pulmonary infections.

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“…Therefore, the inability to generate normal inspiratory pressures can impair airway clearance and predisposes individuals to pulmonary infections. Pneumonia is a common pulmonary complication with aging [60–62], and CHF patients have increased risk of hospitalization due to pneumonia [63,64]. While multiple factors will determine the higher incidence of pneumonia with aging and CHF, there is a likely contribution from the loss of inspiratory function.…”

Section: Relevance Of Inspiratory Muscle Dysfunction To Chf and Agmentioning

confidence: 99%

Diaphragm abnormalities in heart failure and aging: mechanisms and integration of cardiovascular and respiratory pathophysiology

Kelley

Ferreira

2016

Heart Fail Rev

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Inspiratory function is essential for alveolar ventilation and expulsive behaviors that promote airway clearance (e.g., coughing and sneezing). Current evidence demonstrates that inspiratory dysfunction occurs during healthy aging and is accentuated by chronic heart failure (CHF). This inspiratory dysfunction contributes to key aspects of CHF and aging cardiovascular and pulmonary pathophysiology including: i) impaired airway clearance and predisposition to pneumonia; ii) inability to sustain ventilation during physical activity; iii) shallow breathing pattern that limits alveolar ventilation and gas exchange; and iv) sympathetic activation that causes cardiac arrhythmias and tissue vasoconstriction. The diaphragm is the primary inspiratory muscle, hence, its neuromuscular integrity is a main determinant of the adequacy of inspiratory function. Mechanistic work within animal and cellular models has revealed specific factors that may be responsible for diaphragm neuromuscular abnormalities in CHF and aging. These include phrenic nerve and neuromuscular junction alterations as well as intrinsic myocyte abnormalities, such as changes in the quantity and quality of contractile proteins, accelerated fiber atrophy, and shifts in fiber type distribution. CHF, aging, or CHF in the presence of aging disturbs the dynamics of circulating factors (e.g., cytokines and angiotensin II) and cell signaling involving sphingolipids, reactive oxygen species, and proteolytic pathways, thus leading to the previously listed abnormalities. Exercise-based rehabilitation combined with pharmacological therapies targeting the pathways reviewed herein hold promise to treat diaphragm abnormalities and inspiratory muscle dysfunction in CHF and aging.

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Chronic heart failure and risk of hospitalization with pneumonia: A population-based study

Cited by 46 publications

References 30 publications

Decompensated Heart Failure Is a Strong Independent Predictor of Functional Outcome After Ischemic Stroke

Decompensated Heart Failure Is a Strong Independent Predictor of Functional Outcome After Ischemic Stroke

Association of COPD With Risk for Pulmonary Infections Requiring Hospitalization in HIV-Infected Veterans

Diaphragm abnormalities in heart failure and aging: mechanisms and integration of cardiovascular and respiratory pathophysiology

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