COPD: CardiOPulmonary Disease?

C hronic obstructive pulmonary disease (COPD) is defined by the presence of airflow limitation which is not fully reversible, but COPD encompasses numerous phenotypes [1]. Phenotypes are the products of genetic and environmental interactions, with ‘‘environment’’ being broadly defined. The systematic measurement and analysis of clinical and other qualitative and quantitative traits may refine COPD phenotypes, features of which may be shared between different disease states [2, 3]. HAN et al. [4] have defined clinical phenotypes in COPD as ‘‘a single or combination of disease attributes that describe differences between individuals with COPD as they relate to clinically meaningful outcomes (symptoms, exacerbations, response to therapy, rate of disease progression, or death).’’ Identification of such phenotypes would not only facilitate outcome prediction and ‘‘personalised’’ treatment, but also improve the understanding of critical biological and mechanistic disease pathways. The systemic impact of COPD has led to consideration of extrapulmonary disease manifestations in recent efforts to construct these phenotypes.