Skip to main content

Cardiovascular Comorbidity in Chronic Lung Disease: Epidemiology, Clinical Manifestations, and Diagnosis

  • Chapter
  • First Online:
Cardiac Considerations in Chronic Lung Disease

Part of the book series: Respiratory Medicine ((RM))

  • 511 Accesses

Abstract

Chronic lung diseases account for a substantial amount of morbidity and disability. Chronic lung diseases and cardiovascular disease are both very prevalent but their co-existence is not explained by chance but by the risk of atherosclerosis and deranged cardiopulmonary interactions conferred by the presence of chronic lung disease. A low index of suspicion should be maintained to evaluate for chronic lung or cardiovascular disease when one of these is present, especially when symptoms and functional impairment is deemed to be out of proportion for the existing diagnosis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ma J, Ward EM, Siegel RL, Jemal A. Temporal trends in mortality in the United States, 1969-2013. JAMA. 2015;314:1731–9.

    Article  CAS  PubMed  Google Scholar 

  2. Mannino DM, McBurnie MA, Tan W, Kocabas A, Anto J, Vollmer WM, Buist AS, BOLD Collaborative Research Group. Restricted spirometry in the Burden of Lung Disease Study. Int J Tuberc Lung Dis. 2012;16(10):1405–11.

    CAS  PubMed  Google Scholar 

  3. Ford ES, Croft JB, Mannino DM, Wheaton AG, Zhang X, Giles WH. COPD surveillance – United States, 1999-2011. Chest. 2013;144:284–305.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Mazurek JM, Syamlal G. Prevalence of asthma, asthma attacks, and emergency department visits for asthma among working adults – National Health Interview Survey, 2011-2016. MMWR Morb Mortal Wkly Rep. 2018;67:377–86.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, de Ferranti SD, Floyd J, Fornage M, Gillespie C, Isasi CR, Jimenez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Mackey RH, Matsushita K, Mozaffarian D, Mussolino ME, Nasir K, Neumar RW, Palaniappan L, Pandey DK, Thiagarajan RR, Reeves MJ, Ritchey M, Rodriguez CJ, Roth GA, Rosamond WD, Sasson C, Towfighi A, Tsao CW, Turner MB, Virani SS, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P, American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2017 update: a report from the American Heart Association. Circulation. 2017;135:e146–603.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Bhatt SP, Dransfield MT. Chronic obstructive pulmonary disease and cardiovascular disease. Transl Res. 2013;162:237–51.

    Article  PubMed  Google Scholar 

  7. Sin DD, Man SF. Chronic obstructive pulmonary disease as a risk factor for cardiovascular morbidity and mortality. Proc Am Thorac Soc. 2005;2:8–11.

    Article  PubMed  Google Scholar 

  8. Chen W, Thomas J, Sadatsafavi M, FitzGerald JM. Risk of cardiovascular comorbidity in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Lancet Respir Med. 2015;3:631–9.

    Article  PubMed  Google Scholar 

  9. Hole DJ, Watt GC, Davey-Smith G, Hart CL, Gillis CR, Hawthorne VM. Impaired lung function and mortality risk in men and women: findings from the Renfrew and Paisley prospective population study. BMJ. 1996;313:711–5; discussion 715–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Anthonisen NR, Connett JE, Enright PL, Manfreda J, Lung Health Study Research Group. Hospitalizations and mortality in the Lung Health Study. Am J Respir Crit Care Med. 2002;166:333–9.

    Article  PubMed  Google Scholar 

  11. Duong M, Islam S, Rangarajan S, Leong D, Kurmi O, Teo K, Killian K, Dagenais G, Lear S, Wielgosz A, Nair S, Mohan V, Mony P, Gupta R, Kumar R, Rahman O, Yusoff K, du Plessis JL, Igumbor EU, Chifamba J, Li W, Lu Y, Zhi F, Yan R, Iqbal R, Ismail N, Zatonska K, Karsidag K, Rosengren A, Bahonar A, Yusufali A, Lamelas PM, Avezum A, Lopez-Jaramillo P, Lanas F, O’Byrne PM, Yusuf S, PURE Investigators. Mortality and cardiovascular and respiratory morbidity in individuals with impaired FEV1 (PURE): an international, community-based cohort study. Lancet Glob Health. 2019;7:e613–23.

    Article  PubMed  Google Scholar 

  12. Cazzola M, Bettoncelli G, Sessa E, Cricelli C, Biscione G. Prevalence of comorbidities in patients with chronic obstructive pulmonary disease. Respiration. 2010;80:112–9.

    Article  PubMed  Google Scholar 

  13. Curkendall SM, DeLuise C, Jones JK, Lanes S, Stang MR, Goehring E Jr, She D. Cardiovascular disease in patients with chronic obstructive pulmonary disease, Saskatchewan Canada cardiovascular disease in COPD patients. Ann Epidemiol. 2006;16:63–70.

    Article  PubMed  Google Scholar 

  14. Feary JR, Rodrigues LC, Smith CJ, Hubbard RB, Gibson JE. Prevalence of major comorbidities in subjects with COPD and incidence of myocardial infarction and stroke: a comprehensive analysis using data from primary care. Thorax. 2010;65:956–62.

    Article  PubMed  Google Scholar 

  15. Mannino DM, Thorn D, Swensen A, Holguin F. Prevalence and outcomes of diabetes, hypertension and cardiovascular disease in COPD. Eur Respir J. 2008;32:962–9.

    Article  CAS  PubMed  Google Scholar 

  16. Sode BF, Dahl M, Nordestgaard BG. Myocardial infarction and other co-morbidities in patients with chronic obstructive pulmonary disease: a Danish nationwide study of 7.4 million individuals. Eur Heart J. 2011;32:2365–75.

    Article  PubMed  Google Scholar 

  17. Kannel WB, Hubert H, Lew EA. Vital capacity as a predictor of cardiovascular disease: the Framingham study. Am Heart J. 1983;105:311–5.

    Article  CAS  PubMed  Google Scholar 

  18. Schroeder EB, Welch VL, Couper D, Nieto FJ, Liao D, Rosamond WD, Heiss G. Lung function and incident coronary heart disease: the Atherosclerosis Risk in Communities Study. Am J Epidemiol. 2003;158:1171–81.

    Article  PubMed  Google Scholar 

  19. Kizer JR, Zisman DA, Blumenthal NP, Kotloff RM, Kimmel SE, Strieter RM, Arcasoy SM, Ferrari VA, Hansen-Flaschen J. Association between pulmonary fibrosis and coronary artery disease. Arch Intern Med. 2004;164:551–6.

    Article  PubMed  Google Scholar 

  20. Izbicki G, Ben-Dor I, Shitrit D, Bendayan D, Aldrich TK, Kornowski R, Kramer MR. The prevalence of coronary artery disease in end-stage pulmonary disease: is pulmonary fibrosis a risk factor? Respir Med. 2009;103:1346–9.

    Article  PubMed  Google Scholar 

  21. Hubbard RB, Smith C, Le Jeune I, Gribbin J, Fogarty AW. The association between idiopathic pulmonary fibrosis and vascular disease: a population-based study. Am J Respir Crit Care Med. 2008;178:1257–61.

    Article  PubMed  Google Scholar 

  22. Liu H, Fu Y, Wang K. Asthma and risk of coronary heart disease: a meta-analysis of cohort studies. Ann Allergy Asthma Immunol. 2017;118:689–95.

    Article  PubMed  Google Scholar 

  23. Behar S, Panosh A, Reicher-Reiss H, Zion M, Schlesinger Z, Goldbourt U. Prevalence and prognosis of chronic obstructive pulmonary disease among 5,839 consecutive patients with acute myocardial infarction. SPRINT Study Group. Am J Med. 1992;93:637–41.

    Article  CAS  PubMed  Google Scholar 

  24. Soriano JB, Rigo F, Guerrero D, Yanez A, Forteza JF, Frontera G, Togores B, Agusti A. High prevalence of undiagnosed airflow limitation in patients with cardiovascular disease. Chest. 2010;137:333–40.

    Article  PubMed  Google Scholar 

  25. Finkelstein J, Cha E, Scharf SM. Chronic obstructive pulmonary disease as an independent risk factor for cardiovascular morbidity. Int J Chron Obstruct Pulmon Dis. 2009;4:337–49.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Schnell K, Weiss CO, Lee T, Krishnan JA, Leff B, Wolff JL, Boyd C. The prevalence of clinically-relevant comorbid conditions in patients with physician-diagnosed COPD: a cross-sectional study using data from NHANES 1999-2008. BMC Pulm Med. 2012;12:26.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Strachan DP. Ventilatory function as a predictor of fatal stroke. BMJ. 1991;302:84–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Wannamethee SG, Shaper AG, Ebrahim S. Respiratory function and risk of stroke. Stroke. 1995;26:2004–10.

    Article  CAS  PubMed  Google Scholar 

  29. Truelsen T, Prescott E, Lange P, Schnohr P, Boysen G. Lung function and risk of fatal and non-fatal stroke. The Copenhagen City Heart Study. Int J Epidemiol. 2001;30:145–51.

    Article  CAS  PubMed  Google Scholar 

  30. Gulsvik AK, Gulsvik A, Skovlund E, Thelle DS, Mowe M, Humerfelt S, Wyller TB. The association between lung function and fatal stroke in a community followed for 4 decades. J Epidemiol Community Health. 2012;66:1030–6.

    Article  PubMed  Google Scholar 

  31. Portegies ML, Lahousse L, Joos GF, Hofman A, Koudstaal PJ, Stricker BH, Brusselle GG, Ikram MA. Chronic obstructive pulmonary disease and the risk of stroke. The Rotterdam Study. Am J Respir Crit Care Med. 2016;193:251–8.

    Article  CAS  PubMed  Google Scholar 

  32. Wen LY, Ni H, Li KS, Yang HH, Cheng J, Wang X, Zhao DS, Xie MY, Su H. Asthma and risk of stroke: a systematic review and meta-analysis. J Stroke Cerebrovasc Dis. 2016;25:497–503.

    Article  PubMed  Google Scholar 

  33. Kim SY, Lim H, Lim JS, Choi HG. Analysis of the relationship between adult asthma and stroke: a longitudinal follow-up study using the Korean National sample cohort. Biomed Res Int. 2019;2019:8919230.

    PubMed  PubMed Central  Google Scholar 

  34. Strand LB, Tsai MK, Wen CP, Chang SS, Brumpton BM. Is having asthma associated with an increased risk of dying from cardiovascular disease? A prospective cohort study of 446 346 Taiwanese adults. BMJ Open. 2018;8:e019992.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Houben-Wilke S, Jorres RA, Bals R, Franssen FM, Glaser S, Holle R, Karch A, Koch A, Magnussen H, Obst A, Schulz H, Spruit MA, Wacker ME, Welte T, Wouters EF, Vogelmeier C, Watz H. Peripheral artery disease and its clinical relevance in patients with chronic obstructive pulmonary disease in the COPD and Systemic Consequences-Comorbidities Network Study. Am J Respir Crit Care Med. 2017;195:189–97.

    Article  PubMed  Google Scholar 

  36. Camiciottoli G, Bigazzi F, Magni C, Bonti V, Diciotti S, Bartolucci M, Mascalchi M, Pistolesi M. Prevalence of comorbidities according to predominant phenotype and severity of chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2016;11:2229–36.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Liao KM, Kuo LT, Lu HY. Increased risk of peripheral arterial occlusive diseases in patients with chronic obstructive pulmonary disease: a nationwide study in Taiwan. Int J Chron Obstruct Pulmon Dis. 2019;14:1455–64.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Terzikhan N, Lahousse L, Verhamme KMC, Franco OH, Ikram AM, Stricker BH, Brusselle GG. COPD is associated with an increased risk of peripheral artery disease and mortality. ERJ Open Res. 2018;4:00086.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Tschopp J, Dumont P, Hayoz D. True prevalence of COPD and its association with peripheral arterial disease in the internal medicine ward of a tertiary care hospital. Swiss Med Wkly. 2017;147:w14460.

    PubMed  Google Scholar 

  40. Pecci R, De La Fuente Aguado J, Sanjurjo Rivo AB, Sanchez Conde P, Corbacho Abelaira M. Peripheral arterial disease in patients with chronic obstructive pulmonary disease. Int Angiol. 2012;31:444–53.

    CAS  PubMed  Google Scholar 

  41. Yao CW, Shen TC, Lu CR, Wang YC, Lin CL, Tu CY, Hsia TC, Shih CM, Hsu WH, Sung FC. Asthma is associated with a subsequent risk of peripheral artery disease: a longitudinal population-based study. Medicine (Baltimore). 2016;95:e2546.

    Article  Google Scholar 

  42. Rutten FH, Cramer MJ, Grobbee DE, Sachs AP, Kirkels JH, Lammers JW, Hoes AW. Unrecognized heart failure in elderly patients with stable chronic obstructive pulmonary disease. Eur Heart J. 2005;26:1887–94.

    Article  PubMed  Google Scholar 

  43. Georgiopoulou VV, Kalogeropoulos AP, Psaty BM, Rodondi N, Bauer DC, Butler AB, Koster A, Smith AL, Harris TB, Newman AB, Kritchevsky SB, Butler J. Lung function and risk for heart failure among older adults: the Health ABC Study. Am J Med. 2011;124:334–41.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Engstrom G, Melander O, Hedblad B. Population-based study of lung function and incidence of heart failure hospitalisations. Thorax. 2010;65:633–8.

    Article  PubMed  Google Scholar 

  45. Alter P, Watz H, Kahnert K, Pfeifer M, Randerath WJ, Andreas S, Waschki B, Kleibrink BE, Welte T, Bals R, Schulz H, Biertz F, Young D, Vogelmeier CF, Jorres RA. Airway obstruction and lung hyperinflation in COPD are linked to an impaired left ventricular diastolic filling. Respir Med. 2018;137:14–22.

    Article  PubMed  Google Scholar 

  46. Kubota Y, Asai K, Murai K, Tsukada YT, Hayashi H, Saito Y, Azuma A, Gemma A, Shimizu W. COPD advances in left ventricular diastolic dysfunction. Int J Chron Obstruct Pulmon Dis. 2016;11:649–55.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Malerba M, Ragnoli B, Salameh M, Sennino G, Sorlini ML, Radaeli A, Clini E. Sub-clinical left ventricular diastolic dysfunction in early stage of chronic obstructive pulmonary disease. J Biol Regul Homeost Agents. 2011;25:443–51.

    CAS  PubMed  Google Scholar 

  48. Sabit R, Bolton CE, Fraser AG, Edwards JM, Edwards PH, Ionescu AA, Cockcroft JR, Shale DJ. Sub-clinical left and right ventricular dysfunction in patients with COPD. Respir Med. 2010;104:1171–8.

    Article  PubMed  Google Scholar 

  49. Funk GC, Lang I, Schenk P, Valipour A, Hartl S, Burghuber OC. Left ventricular diastolic dysfunction in patients with COPD in the presence and absence of elevated pulmonary arterial pressure. Chest. 2008;133:1354–9.

    Article  PubMed  Google Scholar 

  50. Schena M, Clini E, Errera D, Quadri A. Echo-Doppler evaluation of left ventricular impairment in chronic cor pulmonale. Chest. 1996;109:1446–51.

    Article  CAS  PubMed  Google Scholar 

  51. Freixa X, Portillo K, Pare C, Garcia-Aymerich J, Gomez FP, Benet M, Roca J, Farrero E, Ferrer J, Fernandez-Palomeque C, Antó JM, Barbera JA, PAC-COPD Study Investigators. Echocardiographic abnormalities in patients with copd at their first hospital admission. Eur Respir J. 2013;41(4):784–91.

    Article  PubMed  Google Scholar 

  52. Barr RG, Bluemke DA, Ahmed FS, Carr JJ, Enright PL, Hoffman EA, Jiang R, Kawut SM, Kronmal RA, Lima JA, Shahar E, Smith LJ, Watson KE. Percent emphysema, airflow obstruction, and impaired left ventricular filling. N Engl J Med. 2010;362:217–27.

    Article  PubMed  PubMed Central  Google Scholar 

  53. McCord J, Borzak S. Multifocal atrial tachycardia. Chest. 1998;113:203–9.

    Article  CAS  PubMed  Google Scholar 

  54. Levine JH, Michael JR, Guarnieri T. Multifocal atrial tachycardia: a toxic effect of theophylline. Lancet. 1985;1:12–4.

    Article  CAS  PubMed  Google Scholar 

  55. Shih HT, Webb CR, Conway WA, Peterson E, Tilley B, Goldstein S. Frequency and significance of cardiac arrhythmias in chronic obstructive lung disease. Chest. 1988;94:44–8.

    Article  CAS  PubMed  Google Scholar 

  56. Buch P, Friberg J, Scharling H, Lange P, Prescott E. Reduced lung function and risk of atrial fibrillation in the Copenhagen City Heart Study. Eur Respir J. 2003;21:1012–6.

    Article  CAS  PubMed  Google Scholar 

  57. Li J, Agarwal SK, Alonso A, Blecker S, Chamberlain AM, London SJ, Loehr LR, McNeill AM, Poole C, Soliman EZ, Heiss G. Airflow obstruction, lung function, and incidence of atrial fibrillation: the Atherosclerosis Risk in Communities (ARIC) study. Circulation. 2014;129:971–80.

    Article  PubMed  Google Scholar 

  58. Konecny T, Park JY, Somers KR, Konecny D, Orban M, Soucek F, Parker KO, Scanlon PD, Asirvatham SJ, Brady PA, Rihal CS. Relation of chronic obstructive pulmonary disease to atrial and ventricular arrhythmias. Am J Cardiol. 2014;114:272–7.

    Article  PubMed  Google Scholar 

  59. Tukek T, Yildiz P, Akkaya V, Karan MA, Atilgan D, Yilmaz V, Korkut F. Factors associated with the development of atrial fibrillation in COPD patients: the role of P-wave dispersion. Ann Noninvasive Electrocardiol. 2002;7:222–7.

    Article  PubMed  Google Scholar 

  60. Bhatt SP, Nanda S, Kintzer JS. Arrhythmias as trigger for acute exacerbations of chronic obstructive pulmonary disease. Respir Med. 2012;106:1134–8.

    Article  PubMed  Google Scholar 

  61. Sarubbi B, Esposito V, Ducceschi V, Meoli I, Grella E, Santangelo L, Iacano A, Caputi M. Effect of blood gas derangement on QTc dispersion in severe chronic obstructive pulmonary disease: evidence of an electropathy? Int J Cardiol. 1997;58:287–92.

    Article  CAS  PubMed  Google Scholar 

  62. Warnier MJ, Blom MT, Bardai A, Berdowksi J, Souverein PC, Hoes AW, Rutten FH, de Boer A, Koster RW, De Bruin ML, Tan HL. Increased risk of sudden cardiac arrest in obstructive pulmonary disease: a case-control study. PLoS One. 2013;8:e65638.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  63. Lahousse L, Niemeijer MN, van den Berg ME, Rijnbeek PR, Joos GF, Hofman A, Franco OH, Deckers JW, Eijgelsheim M, Stricker BH, Brusselle GG. Chronic obstructive pulmonary disease and sudden cardiac death: the Rotterdam study. Eur Heart J. 2015;36:1754–61.

    Article  PubMed  Google Scholar 

  64. van den Berg ME, Stricker BH, Brusselle GG, Lahousse L. Chronic obstructive pulmonary disease and sudden cardiac death: a systematic review. Trends Cardiovasc Med. 2016;26:606–13.

    Article  PubMed  Google Scholar 

  65. Iribarren C, Round AD, Peng JA, Lu M, Klatsky AL, Zaroff JG, Holve TJ, Prasad A, Stang P. Short QT in a cohort of 1.7 million persons: prevalence, correlates, and prognosis. Ann Noninvasive Electrocardiol. 2014;19:490–500.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Tukek T, Yildiz P, Atilgan D, Tuzcu V, Eren M, Erk O, Demirel S, Akkaya V, Dilmener M, Korkut F. Effect of diurnal variability of heart rate on development of arrhythmia in patients with chronic obstructive pulmonary disease. Int J Cardiol. 2003;88:199–206.

    Article  PubMed  Google Scholar 

  67. Hawkins NM, Petrie MC, Jhund PS, Chalmers GW, Dunn FG, McMurray JJ. Heart failure and chronic obstructive pulmonary disease: diagnostic pitfalls and epidemiology. Eur J Heart Fail. 2009;11:130–9.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Le Jemtel TH, Padeletti M, Jelic S. Diagnostic and therapeutic challenges in patients with coexistent chronic obstructive pulmonary disease and chronic heart failure. J Am Coll Cardiol. 2007;49:171–80.

    Article  PubMed  Google Scholar 

  69. Naum CC, Sciurba FC, Rogers RM. Pulmonary function abnormalities in chronic severe cardiomyopathy preceding cardiac transplantation. Am Rev Respir Dis. 1992;145:1334–8.

    Article  CAS  PubMed  Google Scholar 

  70. Light RW, George RB. Serial pulmonary function in patients with acute heart failure. Arch Intern Med. 1983;143:429–33.

    Article  CAS  PubMed  Google Scholar 

  71. Guder G, Rutten FH, Brenner S, Angermann CE, Berliner D, Ertl G, Jany B, Lammers JW, Hoes AW, Stork S. The impact of heart failure on the classification of COPD severity. J Card Fail. 2012;18:637–44.

    Article  PubMed  Google Scholar 

  72. Thomason JW, Ely EW, Chiles C, Ferretti G, Freimanis RI, Haponik EF. Appraising pulmonary edema using supine chest roentgenograms in ventilated patients. Am J Respir Crit Care Med. 1998;157:1600–8.

    Article  CAS  PubMed  Google Scholar 

  73. Martin GS, Ely EW, Carroll FE, Bernard GR. Findings on the portable chest radiograph correlate with fluid balance in critically ill patients. Chest. 2002;122:2087–95.

    Article  PubMed  Google Scholar 

  74. Lichtenstein DA, Meziere GA. Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol. Chest. 2008;134:117–25.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Picano E, Frassi F, Agricola E, Gligorova S, Gargani L, Mottola G. Ultrasound lung comets: a clinically useful sign of extravascular lung water. J Am Soc Echocardiogr. 2006;19:356–63.

    Article  PubMed  Google Scholar 

  76. Mayo PH, Copetti R, Feller-Kopman D, Mathis G, Maury E, Mongodi S, Mojoli F, Volpicelli G, Zanobetti M. Thoracic ultrasonography: a narrative review. Intensive Care Med. 2019;45:1200–11.

    Article  CAS  PubMed  Google Scholar 

  77. Gerges C, Gerges M, Lang MB, Zhang Y, Jakowitsch J, Probst P, Maurer G, Lang IM. Diastolic pulmonary vascular pressure gradient: a predictor of prognosis in “out-of-proportion” pulmonary hypertension. Chest. 2013;143:758–66.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Surya P. Bhatt .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Bhatt, S.P. (2020). Cardiovascular Comorbidity in Chronic Lung Disease: Epidemiology, Clinical Manifestations, and Diagnosis. In: Bhatt, S. (eds) Cardiac Considerations in Chronic Lung Disease. Respiratory Medicine. Humana, Cham. https://doi.org/10.1007/978-3-030-43435-9_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-43435-9_1

  • Published:

  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-030-43434-2

  • Online ISBN: 978-3-030-43435-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics