Vol. 5 No. 1 (2026): January–February
21-31
2026-02-27
Open Access

Chronic obstructive pulmonary disease and congestive heart failure: iarc-icpms. Three clinical applications of the human gene: a narrative literature review of comorbidity, pathophysiology, diagnosis, and management

Abdigaffor G.Gadayev
Rustam I.Turakulov
Bakhtiyor A.Nurullayev
DOI: https://doi.org/10.56121/MSU-2026-1-00003

Received: 2026-01-05 12:23:15

Published: 2026-02-27

PDF
Crossmark Crossmark

Abstract

Chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF) are among the leading causes of morbidity and mortality in the world. The high comorbidity burden presents important clinical challenges in exacerbating the issues of diagnosis and treatment due to overlapping symptom profiles, shared risk factors, and interconnected pathophysiological processes. This narrative review summarizes recent evidence on the epidemiology, pathophysiology, diagnostic challenges and therapeutic strategies for these patients. Peer-reviewed studies were identified by conducting a systematic search of PubMed, MEDLINE, and EMBASE from 2016 to 2024. Existing data suggests that COPD occurs in 20–30\% of patients with CHF, and a comparable proportion of moderate-to-severe COPD has left ventricular dysfunction. Coginitive impairment is an independent predictor of adverse clinical outcomes, including higher rates of hospitalization and mortality. Systemic inflammation, oxidative stress, skeletal muscle dysfunction and neurohormonal activation are shared pathways linking these different diseases. Differential diagnosis is limited because of clinical symptom overlap; however, each mentioned biomarker has complementary diagnostic utility in general: natriuretic peptides will identify pulmonary hypertension due to left heart failure, echocardiography can assess underlying structural heart disease and pulmonary function testing helps characterize the underlying pathology. Management should be a personalized and multi-faceted approach focusing on drug safety related to beta-blockers and bronchodilators along with non-pharmacologic strategies such as pulmonary rehabilitation and cardiac rehabilitation. This review underscores the need for joint clinical assessment and supports more prospective studies of this high-risk group.

Keywords

List of references

  1. Adeloye D., Song P., Zhu Y., et al. (2022). Global, regional, and national prevalence of, and risk factors for, chronic obstructive pulmonary disease (COPD) in 2019: a systematic review and modelling analysis. Lancet Respiratory Medicine, 10(5), 447–458. https://doi.org/10.1016/S2213-2600(21)00511-7.

  2. Agusti A., & Faner R. (2017). Systemic inflammation and comorbidities in chronic obstructive pulmonary disease. Proceedings of the American Thoracic Society, 14(3), 219–226. https://doi.org/10.1513/AnnalsATS.201606-469AW}.

  3. Anker S. D., Butler J., Filippatos G., et al. (2021). Empagliflozin in heart failure with a preserved ejection fraction. New England Journal of Medicine, 385(16), 1451–1461. https://doi.org/10.1056/NEJMoa2107038.

  4. Müllerová H., Agusti A., Erqou S., & Mapel D. W. (2020). Cardiovascular comorbidity in COPD: systematic literature review. Chest, 141(5), 1233–1241. https://doi.org/10.1378/chest.11-0890.

  5. Barnes P. J. (2016). Inflammatory mechanisms in patients with chronic obstructive pulmonary disease. Journal of Allergy and Clinical Immunology, 138(1), 16–27. https://doi.org/10.1016/j.jaci.2016.05.011.

  6. Bhatt S. P., Dransfield M. T., Bhatt S. P., et al. (2021). Cardiovascular safety of indacaterol-glycopyrronium versus salmeterol-fluticasone in COPD: FLAME trial. American Journal of Respiratory and Critical Care Medicine, 204(5), 531–542. https://doi.org/10.1164/rccm.202006-2606OC.

  7. Mentz R. J., Kelly J. P., von Lueder T. G., et al. (2016). Noncardiac comorbidities in heart failure with reduced versus preserved ejection fraction. Journal of the American College of Cardiology, 64(21), 2281–2293. https://doi.org/10.1016/j.jacc.2014.08.036.

  8. Vestbo J., Anderson J. A., Brook R. D., et al. (2016). Fluticasone furoate and vilanterol and survival in chronic obstructive pulmonary disease with heightened cardiovascular risk (SUMMIT): a double-blind randomised controlled trial. Lancet, 387(10030), 1817–1826. https://doi.org/10.1016/S0140-6736(16)30069-1.

  9. Schiattarella G. G., & Hill J. A. (2018). Inhibition of hypertrophy is a good therapeutic strategy in ventricular pressure overload. Circulation, 131(16), 1435–1447. https://doi.org/10.1161/CIRCULATIONAHA.115.013894.

  10. Chow S. L., Maisel A. S., Anand I., et al. (2017). Role of biomarkers for the prevention, assessment, and management of heart failure: a scientific statement from the American Heart Association. Circulation, 135(22), e1054–e1091. https://doi.org/10.1161/CIR.0000000000000490.

  11. Januzzi J. L., & Mann D. L. (2019). Natriuretic peptide measurement in heart failure: the good, the bad, and the future. JACC: Heart Failure, 7(4), 299–301. https://doi.org/10.1016/j.jchf.2019.01.007.

  12. Srivaratharajah K., Coutinho T., deKemp R., et al. (2016). Reduced myocardial flow in heart failure patients with preserved ejection fraction. Circulation: Heart Failure, 9(7), e002562. https://doi.org/10.1161/CIRCHEARTFAILURE.115.002562.

  13. Agustí A., Celli B. R., Criner G. J., et al. (2023). Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary. American Journal of Respiratory and Critical Care Medicine, 207(7), 819–837. https://doi.org/10.1164/rccm.202301-0106PP.

  14. Maltais F., Decramer M., Casaburi R., et al. (2014). An official American Thoracic Society/European Respiratory Society statement: update on limb muscle dysfunction in chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine, 189(9), e15–e62. https://doi.org/10.1164/rccm.201402-0373ST.

  15. Groenewegen A., Rutten F. H., Mosterd A., & Hoes A. W. (2020). Epidemiology of heart failure. European Journal of Heart Failure, 22(8), 1342–1356. https://doi.org/10.1002/ejhf.1858.

  16. Guazzi M., Arena R., Halle M., Piepoli M. F., Myers J., & Lavie C. J. (2016). 2016 Focused Update: Clinical Recommendations for Cardiopulmonary Exercise Testing Data Assessment in Specific Patient Populations. Circulation, 133(24), e694–e711. https://doi.org/10.1161/CIR.0000000000000406.

  17. Rutten F. H., Cramer M. J., Lammers J. W., Grobbee D. E., & Hoes A. W. (2016). Heart failure and chronic obstructive pulmonary disease: an ignored combination? European Journal of Heart Failure, 8(7), 706–711. https://doi.org/10.1016/j.ejheart.2006.01.010.

  18. Lipworth B., Skinner D., Devereux G., et al. (2016). Underuse of beta-blockers in heart failure complicated by chronic obstructive pulmonary disease. Heart, 102(23), 1909–1914. https://doi.org/10.1136/heartjnl-2016-309458.

  19. Holland A. E., Mahal A., Hill C. J., et al. (2017). Home-based rehabilitation for COPD using minimal resources: A randomised controlled equivalence trial. Thorax, 72(1), 57–65. https://doi.org/10.1136/thoraxjnl-2016-208514.

  20. Tham Y. K., Bernardo B. C., Ooi J. Y. Y., Weeks K. L., & McMullen J. R. (2017). Pathophysiology of cardiac hypertrophy and heart failure: signaling pathways and novel therapeutic targets. Archives of Toxicology, 89(9), 1401–1438. https://doi.org/10.1007/s00204-015-1477-x.

  21. GBD 2019 Diseases and Injuries Collaborators. (2020). Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet, 396(10258), 1204–1222. https://doi.org/10.1016/S0140-6736(20)30925-9.

  22. Januzzi J. L., Prescott M. F., Butler J., et al. (2019). Association of change in N-terminal pro-B-type natriuretic peptide following initiation of sacubitril-valsartan treatment with cardiac structure and function in patients with heart failure. JAMA, 322(11), 1085–1095. https://doi.org/10.1001/jama.2019.12821.

  23. McMurray J. J. V., Solomon S. D., Inzucchi S. E., et al. (2019). Dapagliflozin in patients with heart failure and reduced ejection fraction. New England Journal of Medicine, 381(21), 1995–2008. https://doi.org/10.1056/NEJMoa1911303.

  24. Pellicori P., Kallvikbacka-Bennett A., Dierckx R., et al. (2017). Prognostic significance of changes in ejection fraction in patients with chronic heart failure. Heart, 104(9), 744–751. https://doi.org/10.1136/heartjnl-2017-311614.

  25. Piepoli M. F., Conraads V., Corrà U., et al. (2016). Exercise training in heart failure: From theory to practice. A consensus document of the Heart Failure Association and the European Association for Cardiovascular Prevention and Rehabilitation. European Journal of Heart Failure, 13(4), 347–357. https://doi.org/10.1093/eurjhf/hfr017.

  26. Ponikowski P., Voors A. A., Anker S. D., et al. (2016). 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal, 37(27), 2129–2200. https://doi.org/10.1093/eurheartj/ehw128.

  27. Kirkham P. A., & Barnes P. J. (2016). Oxidative stress in COPD. Chest, 144(1), 266–273. https://doi.org/10.1378/chest.12-2664.

  28. Rutten F. H., Cramer M. J., Lammers J. W., Grobbee D. E., & Hoes A. W. (2016). Heart failure and chronic obstructive pulmonary disease: an ignored combination? European Journal of Heart Failure, 8(7), 706–711. https://doi.org/10.1016/j.ejheart.2006.01.010.

  29. Cazzola M., Rogliani P., Matera M. G., et al. (2019). Cardiovascular effects of bronchodilators: between myths and realities. Expert Opinion on Drug Safety, 18(11), 1017–1028. https://doi.org/10.1080/14740338.2019.1670149.

  30. Bhatt S. P., Wells J. M., Kinney G. L., et al. (2017). Beta-blockers are associated with a reduction in COPD exacerbations. Thorax, 71(1), 8–14. https://doi.org/10.1136/thoraxjnl-2015-207251.

  31. Celli B. R., Locantore N., Yates J., et al. (2019). Inflammatory biomarkers improve clinical prediction of mortality in chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine, 185(10), 1065–1072. https://doi.org/10.1164/rccm.201110-1792OC.

  32. Spruit M. A., Holland A. E., Singh S. J., Tonia T., Ward D. E., & Puhan M. A. (2020). COVID-19: interim guidance on rehabilitation in the hospital and post-hospital phase from a European Respiratory Society and American Thoracic Society-coordinated International Task Force. European Respiratory Journal, 56(6), 2002197. https://doi.org/10.1183/13993003.02197-202.

  33. Peoples J. N., Saraf A., Ghazal N., Pham T. T., & Kwong J. Q. (2019). Mitochondrial dysfunction and oxidative stress in heart disease. Experimental and Molecular Medicine, 51(12), 1–13. https://doi.org/10.1038/s12276-019-0355-7.

  34. Agustí A., Celli B. R., Criner G. J., et al. (2023). Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary. American Journal of Respiratory and Critical Care Medicine, 207(7), 819–837. https://doi.org/10.1164/rccm.202301-0106PP.

  35. Bozbay M., Atalay M. K., Karabay C. Y., et al. (2018). Pulmonary hypertension in patients with chronic obstructive pulmonary disease: hemodynamic, echocardiographic, and clinical evaluation. Cardiology Journal, 25(4), 465–473. https://doi.org/10.5603/CJ.a2017.0147.

  36. World Health Organization. (2023). Chronic obstructive pulmonary disease (COPD) fact sheet. Retrieved from https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd).

About the Authors

Abdigaffor G.Gadayev
abgadaev@yahoo.com
Tashkent state medical university
Rustam I.Turakulov
rustamturakulov571@gmail.com
Tashkent state medical university
Bakhtiyor A.Nurullayev
bahtiyor.nurullayev93@gmail.com
Tashkent state medical university

License

Copyright (c) 2026 Medical science of Uzbekistan

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

1.
Chronic obstructive pulmonary disease and congestive heart failure: iarc-icpms. Three clinical applications of the human gene: a narrative literature review of comorbidity, pathophysiology, diagnosis, and management. MSU [Internet]. 2026 Feb. 27 [cited 2026 May 5];5(1):21-3. Available from: https://fdoctors.uz/index.php/journal/article/view/257
Crossref
Scopus
Google Scholar
Europe PMC

Similar Articles

You may also start an advanced similarity search for this article.


ISSN 2181-3612 (Online)