Pulmonary function and adverse cardiovascular outcomes: Can cardiac function explain the link?

Melissa S. Burroughs Peña, Allison Dunning, Phillip Schulte, Michael T. Durheim, Peter Kussin, William Checkley, Eric J. Velazquez

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background The complex interaction between pulmonary function, cardiac function and adverse cardiovascular events has only been partially described. We sought to describe the association between pulmonary function with left heart structure and function, all-cause mortality and incident cardiovascular hospitalization. Methods This study is a retrospective analysis of patients evaluated in a single tertiary care medical center. We used multivariable linear regression analyses to examine the relationship between FVC and FEV1 with left ventricular ejection fraction (LVEF), left ventricular internal dimension in systole and diastole (LVIDS, LVIDD) and left atrial diameter, adjusting for baseline characteristics, right ventricular function and lung hyperinflation. We also used Cox proportional hazards models to examine the relationship between FVC and FEV1 with all-cause mortality and cardiac hospitalization. Results A total of 1807 patients were included in this analysis with a median age of 61 years and 50% were female. Decreased FVC and FEV1 were both associated with decreased LVEF. In individuals with FVC less than 2.75 L, decreased FVC was associated with increased all-cause mortality after adjusting for left and right heart echocardiographic variables (hazard ratio [HR] 0.49, 95% CI 0.29, 0.82, respectively). Decreased FVC was associated with increased cardiac hospitalization after adjusting for left heart size (HR 0.80, 95% CI 0.67, 0.96), even in patients with normal LVEF (HR 0.75, 95% CI 0.57, 0.97). Conclusion In a tertiary care center reduced pulmonary function was associated with adverse cardiovascular events, a relationship that is not fully explained by left heart remodeling or right heart dysfunction.

Original languageEnglish (US)
Pages (from-to)4-12
Number of pages9
JournalRespiratory Medicine
Volume121
DOIs
StatePublished - Dec 1 2016

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Lung
Stroke Volume
Hospitalization
Tertiary Care Centers
Mortality
Right Ventricular Function
Diastole
Systole
Proportional Hazards Models
Linear Models
Regression Analysis

Keywords

  • Cardiovascular disease
  • Echocardiography
  • Pulmonary function
  • Spirometry

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Burroughs Peña, M. S., Dunning, A., Schulte, P., Durheim, M. T., Kussin, P., Checkley, W., & Velazquez, E. J. (2016). Pulmonary function and adverse cardiovascular outcomes: Can cardiac function explain the link? Respiratory Medicine, 121, 4-12. https://doi.org/10.1016/j.rmed.2016.10.009

Pulmonary function and adverse cardiovascular outcomes : Can cardiac function explain the link? / Burroughs Peña, Melissa S.; Dunning, Allison; Schulte, Phillip; Durheim, Michael T.; Kussin, Peter; Checkley, William; Velazquez, Eric J.

In: Respiratory Medicine, Vol. 121, 01.12.2016, p. 4-12.

Research output: Contribution to journalArticle

Burroughs Peña, MS, Dunning, A, Schulte, P, Durheim, MT, Kussin, P, Checkley, W & Velazquez, EJ 2016, 'Pulmonary function and adverse cardiovascular outcomes: Can cardiac function explain the link?', Respiratory Medicine, vol. 121, pp. 4-12. https://doi.org/10.1016/j.rmed.2016.10.009
Burroughs Peña, Melissa S. ; Dunning, Allison ; Schulte, Phillip ; Durheim, Michael T. ; Kussin, Peter ; Checkley, William ; Velazquez, Eric J. / Pulmonary function and adverse cardiovascular outcomes : Can cardiac function explain the link?. In: Respiratory Medicine. 2016 ; Vol. 121. pp. 4-12.
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abstract = "Background The complex interaction between pulmonary function, cardiac function and adverse cardiovascular events has only been partially described. We sought to describe the association between pulmonary function with left heart structure and function, all-cause mortality and incident cardiovascular hospitalization. Methods This study is a retrospective analysis of patients evaluated in a single tertiary care medical center. We used multivariable linear regression analyses to examine the relationship between FVC and FEV1 with left ventricular ejection fraction (LVEF), left ventricular internal dimension in systole and diastole (LVIDS, LVIDD) and left atrial diameter, adjusting for baseline characteristics, right ventricular function and lung hyperinflation. We also used Cox proportional hazards models to examine the relationship between FVC and FEV1 with all-cause mortality and cardiac hospitalization. Results A total of 1807 patients were included in this analysis with a median age of 61 years and 50{\%} were female. Decreased FVC and FEV1 were both associated with decreased LVEF. In individuals with FVC less than 2.75 L, decreased FVC was associated with increased all-cause mortality after adjusting for left and right heart echocardiographic variables (hazard ratio [HR] 0.49, 95{\%} CI 0.29, 0.82, respectively). Decreased FVC was associated with increased cardiac hospitalization after adjusting for left heart size (HR 0.80, 95{\%} CI 0.67, 0.96), even in patients with normal LVEF (HR 0.75, 95{\%} CI 0.57, 0.97). Conclusion In a tertiary care center reduced pulmonary function was associated with adverse cardiovascular events, a relationship that is not fully explained by left heart remodeling or right heart dysfunction.",
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N2 - Background The complex interaction between pulmonary function, cardiac function and adverse cardiovascular events has only been partially described. We sought to describe the association between pulmonary function with left heart structure and function, all-cause mortality and incident cardiovascular hospitalization. Methods This study is a retrospective analysis of patients evaluated in a single tertiary care medical center. We used multivariable linear regression analyses to examine the relationship between FVC and FEV1 with left ventricular ejection fraction (LVEF), left ventricular internal dimension in systole and diastole (LVIDS, LVIDD) and left atrial diameter, adjusting for baseline characteristics, right ventricular function and lung hyperinflation. We also used Cox proportional hazards models to examine the relationship between FVC and FEV1 with all-cause mortality and cardiac hospitalization. Results A total of 1807 patients were included in this analysis with a median age of 61 years and 50% were female. Decreased FVC and FEV1 were both associated with decreased LVEF. In individuals with FVC less than 2.75 L, decreased FVC was associated with increased all-cause mortality after adjusting for left and right heart echocardiographic variables (hazard ratio [HR] 0.49, 95% CI 0.29, 0.82, respectively). Decreased FVC was associated with increased cardiac hospitalization after adjusting for left heart size (HR 0.80, 95% CI 0.67, 0.96), even in patients with normal LVEF (HR 0.75, 95% CI 0.57, 0.97). Conclusion In a tertiary care center reduced pulmonary function was associated with adverse cardiovascular events, a relationship that is not fully explained by left heart remodeling or right heart dysfunction.

AB - Background The complex interaction between pulmonary function, cardiac function and adverse cardiovascular events has only been partially described. We sought to describe the association between pulmonary function with left heart structure and function, all-cause mortality and incident cardiovascular hospitalization. Methods This study is a retrospective analysis of patients evaluated in a single tertiary care medical center. We used multivariable linear regression analyses to examine the relationship between FVC and FEV1 with left ventricular ejection fraction (LVEF), left ventricular internal dimension in systole and diastole (LVIDS, LVIDD) and left atrial diameter, adjusting for baseline characteristics, right ventricular function and lung hyperinflation. We also used Cox proportional hazards models to examine the relationship between FVC and FEV1 with all-cause mortality and cardiac hospitalization. Results A total of 1807 patients were included in this analysis with a median age of 61 years and 50% were female. Decreased FVC and FEV1 were both associated with decreased LVEF. In individuals with FVC less than 2.75 L, decreased FVC was associated with increased all-cause mortality after adjusting for left and right heart echocardiographic variables (hazard ratio [HR] 0.49, 95% CI 0.29, 0.82, respectively). Decreased FVC was associated with increased cardiac hospitalization after adjusting for left heart size (HR 0.80, 95% CI 0.67, 0.96), even in patients with normal LVEF (HR 0.75, 95% CI 0.57, 0.97). Conclusion In a tertiary care center reduced pulmonary function was associated with adverse cardiovascular events, a relationship that is not fully explained by left heart remodeling or right heart dysfunction.

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