{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T17:08:34Z","timestamp":1775149714137,"version":"3.50.1"},"reference-count":0,"publisher":"Royal College of General Practitioners","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BJGP Open"],"accepted":{"date-parts":[[2026,1,23]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Investigations on the combination of the comorbidities heart failure (HF), asthma\/chronic obstructive pulmonary disease (COPD), and psychosocial distress (PSD) differentiated by asthma\/COPD and HF type or severity are scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To investigate the impact of PSD on prognosis in HF patients with comorbid asthma\/COPD depending on the HF severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design &amp; setting<\/jats:title>\n                    <jats:p>A secondary analysis of the prospective observational cohort RECODE-HF study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      Kaplan-Meier curves (log-rank tests) illustrate the time to the composite endpoint (12-month hospitalization or death) in the asthma\/COPD-PSD subgroups within each NYHA functional class. Prognostic analyses include multivariable Cox proportional hazards regression (\n                      <jats:italic>n<\/jats:italic>\n                      =2499) including potential confounding conditions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 780 endpoints occurred (649 hospitalizations;131 deaths). Kaplan-Meier analysis revealed a significant reduction in estimated mean time to composite endpoint: -31 days (hazard ratio, HR 1.901;CI95% 1.325-2.674) in asthma\/COPD\/PSD+NYHA II; -47 days (HR 1.981;CI95% 1.364-2.879) and -40 days (HR 1.867;CI95% 1.361-2.561) in asthma\/COPD\/PSD+and no-asthma-or-COPD\/PSD+in NYHA III; -93 days in no-asthma-or-COPD\/PSD+NYHA IV (HR 2.457;CI95% 1.015-5.945) (reference no-asthma-or-COPD\/PSD-; NYHA I). Cox regression showed a significant global three-way interaction regarding hospitalization or death between NYHA class, asthma\/COPD, PSD (\n                      <jats:italic>P<\/jats:italic>\n                      =0.037), and a 10.06-fold hazard (CI95% 1.118-90.498) regarding the NYHA class II subgroup*asthma\/COPD*PSD (\n                      <jats:italic>P<\/jats:italic>\n                      =0.039).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Comorbidity of HF, asthma\/COPD and PSD showed an impact on prognosis by the NYHA functional class. Future research needs to investigate the special needs of patients with PSD and asthma\/COPD with focus on those in NYHA class II. PSD screening seems relevant to identify patients with especially poor prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3399\/bjgpo.2025.0083","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T16:10:22Z","timestamp":1775146222000},"page":"BJGPO.2025.0083","source":"Crossref","is-referenced-by-count":0,"title":["Psychosocial distress in heart failure with asthma and chronic obstructive pulmonary disease"],"prefix":"10.3399","author":[{"given":"Sigrid","family":"Boczor","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marion","family":"Eisele","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anja","family":"Rakebrandt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agata","family":"Menzel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Blozik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens-Martin","family":"Tr\u00e4der","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"St\u00f6rk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Herrmann-Lingen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dagmar","family":"L\u00fchmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Scherer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1987","published-online":{"date-parts":[[2026,4,2]]},"container-title":["BJGP Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.3399\/BJGPO.2025.0083","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T16:10:22Z","timestamp":1775146222000},"score":1,"resource":{"primary":{"URL":"http:\/\/bjgpopen.org\/lookup\/doi\/10.3399\/BJGPO.2025.0083"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,2]]},"references-count":0,"alternative-id":["10.3399\/BJGPO.2025.0083"],"URL":"https:\/\/doi.org\/10.3399\/bjgpo.2025.0083","relation":{},"ISSN":["2398-3795"],"issn-type":[{"value":"2398-3795","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,2]]}}}