1) Pulmonary function in stable chronic heart failure (CHF). 2) COPD prevalence, underdiagnosis and overdiagnosis in stable CHF patients and its independent predictors. 3) Systemic inflammation in COPD and stable CHF: is there a synergistic effect?

There is only a small body of literature addressing pulmonary function in
patients with stable chronic heart failure (CHF), although pulmonary
abnormalities associated with CHF may explain part of the symptom and
functional disability encountered in this group of patients. COPD frequently
coexists with CHF and it has an adverse prognostic impact as well as diagnostic
and therapeutic implications. Despite this, accurate and precise data on the
prevalence of COPD in stable CHF are still lacking and COPD remains to be
widely undiagnosed. Finally, although both COPD and CHF show increased systemic
inflammation when studied separately, it is not known whether there is a
synergistic effect when both conditions coexist.

Primary objectives are 1) pulmonary function in stable CHF, 2) COPD prevalence,
under- and overdiagnosis in stable CHF patients, 3) systemic inflammation in
stable CHF: is there a synergistic effect when COPD coexists? Secondary
objectives are 1) independent predictors of COPD in stable CHF, 2) association
between inflammatory markers and various patient characteristics and 3) the
effect of conventional COPD treatment on systemic inflammatory markers,
pulmonary function, quality of life and dyspnoea.

This is a cross-sectional study.

Subjects will undergo the following examinations: 2 laboratory tests (at
baseline and one month later), a chest X-ray, pulmonary function tests
(spirometry with reversibility test, body plethysmography and diffusion for
carbon monoxide with single breath method) and measurement of BMI. They will
also complete the MLHFQ and MRC dyspnoea and Borg scale. COPD de novo patients
who will receive conventional treatment will repeat laboratory test, pulmonary
function tests and same questionnaires 3 months after treatment. Patients with
a lung function indicative of COPD GOLD III will additionally undergo arterial
blood gas sampling to determine whether they belong to COPD GOLD IV in case of
chronic respiratory failure. Participants can have their first blood sample
taken after their visit to the HF nurse or cardiologist, so this will not
require an extra visit to the hospital. The second blood sample and chest X-ray
will take place one month later. Within the next 2 days the patient will get
to know by way of a telephone call whether he or she can be included in the
study. Additional questions (hospitalization, diuretics change, weight gain,
change in NYHA class) to determine whether the subject meets the inclusion
criteria will be asked during this telephone call. When included, the
participant will be scheduled to meet the investigator and undergo all the
investigations on very short term. COPD de novo patients will be followed-up
three months later and thereafter if necessary. The burden of the study is
mainly the time that the patients have to invest. The laboratory tests can
cause haematomas. Some side-effects of the short acting bronchodilator
salbutamol, used routinely to assess reversibility of lung function, have been
reported. However these are usually mild and temporary in nature. The direct
benefit of the study is the finding and treating of otherwise unknown COPD and
gaining better insight regarding the interaction between COPD en CHF.