Emphysema Associated With Worse Outcomes in Heart Failure

Emphysema CT scan
Emphysema CT scan
After 2.1 years of follow-up, 49% of patients who had emphysema on chest CT were readmitted for heart failure and 24% had died.

Emphysema is a common finding during analysis of chest computed tomography (CT)  in people who smoke and are hospitalized for heart failure (HF). This finding is associated with adverse HF events, according to a study published in PLoS One.

The single-center study included 225 patients selected from a clinical database who were diagnosed with HF at hospital discharge. These patients smoked, had a chest CT during hospitalization, and were discharged from a tertiary center between January 1, 2014, and April 1, 2014. The study conformed to guidelines outlined in the Declaration of Helsinki. The Institutional Review Board of Partners Healthcare approved study protocols.

Emphysema was found in 46% of these individuals (155 [69%] men, age 69±11 years, left ventricular ejection fraction [LVEF] 46%±18%; 107 [48%] LVEF <50%). After 2.1 years, 49% were readmitted for HF, and 24% were deceased. Emphysema on CT was associated with higher rates of readmission (adjusted hazard ratio [HR], 2.11; 95% CI, 1.41-3.15; P <.001), longer hospital stays (median 7 days vs 5 days; P =.004), and increased mortality rates (adjusted HR, 1.70; 95% CI, 0.86-3.34; P =.12) in patients with HF.

Findings suggest that patients with both emphysema and HF might benefit from improved therapies for their comorbid diseases. Researchers concluded that future studies “should consider whether initiation of anti-muscarinics, beta-agonists, or inhaled steroids based on the presence of emphysema on chest CT can improve complex HF outcomes.”

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Kohli P, Staziaki PV, Janjua SA, et al. The effect of emphysema on readmission and survival among smokers with heart failure [published July 30, 2018]. PLoS One. 13(7):e0201376.