Chronic heart failure with preserved ejection fraction and chronic obstructive pulmonary disease: pathogenetic parallels, diagnostic challenges and prognostic value
Authors:
Company:
1 National Medical Research Center for Therapy and Preventive Medicine, Moscow, Russian Federation
2 Russian University of Medicine, Moscow, Russian Federation
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Type: Reviews
DOI:
For citation: Smirnova Yu.I., Dzhioeva O.N. Chronic heart failure with preserved ejection fraction and chronic obstructive pulmonary disease: pathogenetic parallels, diagnostic challenges and prognostic value. Creative Cardiology. 2026; 20 (1): 46–57 (in Russ.). DOI: 10.24022/1997-3187-2026-20-1-46-57
Received / Accepted: 14.01.2026 / 14.01.2026
Keywords: cardiorespiratory comorbidity chronic obstructive pulmonary disease heart failure with preserved ejection fraction diastolic dysfunction biomarkers
Abstract
Chronic heart failure with preserved ejection fraction (HFpEF) is a heterogeneous condition that may develop as a complication of non-cardiac diseases, including chronic obstructive pulmonary disease (COPD). Chronic systemic inflammation contributes to the development of diastolic dysfunction, which partly explains the high prevalence of HFpEF among patients with COPD. In addition, common risk factors and symptoms may lead to underdiagnosis of the COPD-HFpEF comorbidity. A significant worsening of prognosis in patients with COPD-HFpEF phenotype requires close
attention to the problem of cardiorespiratory comorbidity within the medical community.
This literature review outlines the pathogenetic parallels between COPD and HFpEF and summarizes the main principles and approaches to diagnosing this comorbidity. The role of biomarkers, including NT-proBNP, BNP, troponins, galectin-3, and soluble ST2 (sST2), is discussed in detail. Special attention is given to the relationship between COPD and anemia, an important prognostic factor in patients with HFpEF. The findings are presented in the form of a diagnostic algorithm, which, according to the authors, may facilitate diagnostic workup and improve the detection of COPD-HFpEF comorbidity.
