• Dimitrios Matamis, Athanasios Papathanasiou, Helen Sineffaki, Dimitra Lepida, and Eytychia Galiatsou.
• Intensive Care Unit, Papageorgiou General Hospital, Thessaloniki, Greece. Electronic address: dmatamis@gmail.com.
• J Crit Care. 2014 Apr 1;29(2):315.e7-14.

PurposeTo estimate the prevalence of previously undiagnosed heart failure in mechanically ventilated patients with severe exacerbation of chronic obstructive pulmonary disease (COPD) and to evaluate the impact of specific heart failure treatment on patients' outcome.Materials And MethodsIn this prospective study, we included 107 consecutive patients with COPD without known history of cardiac disease who were admitted to the intensive care unit (ICU) because of hypercapnic respiratory failure leading to mechanical ventilation.ResultsPatients were divided into 4 groups according to the echocardiographic findings: patients with isolated right or left ventricular failure, biventricular failure, and normal heart function. Three of 4 patients demonstrated findings of heart failure. In 41%, the presence of previously unrecognized left ventricular dysfunction was revealed. Patients with isolated left ventricular dysfunction experienced less days on mechanical ventilation, less intensive care unit days, improved quality of life, and decreased in-hospital and 6-month mortality compared with patients with normal heart.ConclusionsIn mechanically ventilated patients with severe exacerbation of COPD, unrecognized left or right ventricular failure is common. Among patients with isolated left ventricular failure, the early detection and appropriate treatment improves long-term quality of life and may decrease the short- and 6-month morbidity and mortality.Copyright © 2014 Elsevier Inc. All rights reserved.

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