Pulmonary function in patients with reduced left ventricular function

Influence of smoking and cardiac surgery

Bruce David Johnson, Kenneth C. Beck, Lyle J. Olson, Kathy A. O'Malley, Thomas G. Allison, Ray W. Squires, Geraldd T. Gau

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Study objective: The impact of stable, chronic heart failure on baseline pulmonary function remains controversial. Confounding influences include previous coronary artery bypass or valve surgery (CABG), history of obesity, stability of disease, and smoking history. Design: To control for some of the variables affecting pulmonary function in patients with chronic heart failure, we analyzed data in four patient groups, all with left ventricular (LV) dysfunction (LV ejection fraction [LVEF] ≤ 35%): (1) chronic heart failure, nonsmokers, no CABG (n = 78); (2) chronic heart failure, nonsmokers, CABG (n = 46); (3) chronic heart failure, smokers, no CABG (n = 40); and (4) chronic heart failure, smokers, CABG (n = 48). Comparisons were made with age- and gender-matched patients with a history of coronary disease but no LV dysfunction or smoking history (control subjects, n = 112) and to age-predicted norms. Results: Relative to control subjects and percent-predicted values, all groups with chronic heart failure had reduced lung volumes (total lung capacity [TLC] and vital capacity [VC]) and expiratory flows (p < 0.05). CABG had no influence on lung volumes and expiratory flows in smokers, but resulted in a tendency toward a reduced TLC and VC in nonsmokers. Smokers with chronic heart failure had reduced expiratory flows compared to nonsmokers (p < 0.05), indicating an additive effect of smoking. Diffusion capacity of the lung for carbon monoxide (DLCO) was reduced in smokers and in subjects who underwent CABG, but not in patients with chronic heart failure alone. There was no relationship between LV size and pulmonary function in this population, although LV function (cardiac index and stroke volume) was weakly associated with lung volumes and DLCO. Conclusions: We conclude that patients with chronic heart failure have primarily restrictive lung changes with smoking causing a further reduction in expiratory flows.

Original languageEnglish (US)
Pages (from-to)1869-1876
Number of pages8
JournalChest
Volume120
Issue number6
DOIs
StatePublished - 2001

Fingerprint

Left Ventricular Function
Thoracic Surgery
Heart Failure
Smoking
Lung
Total Lung Capacity
Vital Capacity
Left Ventricular Dysfunction
Stroke Volume
History
Lung Volume Measurements
Cardiac Volume
Carbon Monoxide
Coronary Artery Bypass
Coronary Disease
Obesity

Keywords

  • Expiratory airflow
  • Heart failure
  • Spirometry
  • Vital capacity

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Johnson, B. D., Beck, K. C., Olson, L. J., O'Malley, K. A., Allison, T. G., Squires, R. W., & Gau, G. T. (2001). Pulmonary function in patients with reduced left ventricular function: Influence of smoking and cardiac surgery. Chest, 120(6), 1869-1876. https://doi.org/10.1378/chest.120.6.1869

Pulmonary function in patients with reduced left ventricular function : Influence of smoking and cardiac surgery. / Johnson, Bruce David; Beck, Kenneth C.; Olson, Lyle J.; O'Malley, Kathy A.; Allison, Thomas G.; Squires, Ray W.; Gau, Geraldd T.

In: Chest, Vol. 120, No. 6, 2001, p. 1869-1876.

Research output: Contribution to journalArticle

Johnson, BD, Beck, KC, Olson, LJ, O'Malley, KA, Allison, TG, Squires, RW & Gau, GT 2001, 'Pulmonary function in patients with reduced left ventricular function: Influence of smoking and cardiac surgery', Chest, vol. 120, no. 6, pp. 1869-1876. https://doi.org/10.1378/chest.120.6.1869
Johnson, Bruce David ; Beck, Kenneth C. ; Olson, Lyle J. ; O'Malley, Kathy A. ; Allison, Thomas G. ; Squires, Ray W. ; Gau, Geraldd T. / Pulmonary function in patients with reduced left ventricular function : Influence of smoking and cardiac surgery. In: Chest. 2001 ; Vol. 120, No. 6. pp. 1869-1876.
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abstract = "Study objective: The impact of stable, chronic heart failure on baseline pulmonary function remains controversial. Confounding influences include previous coronary artery bypass or valve surgery (CABG), history of obesity, stability of disease, and smoking history. Design: To control for some of the variables affecting pulmonary function in patients with chronic heart failure, we analyzed data in four patient groups, all with left ventricular (LV) dysfunction (LV ejection fraction [LVEF] ≤ 35{\%}): (1) chronic heart failure, nonsmokers, no CABG (n = 78); (2) chronic heart failure, nonsmokers, CABG (n = 46); (3) chronic heart failure, smokers, no CABG (n = 40); and (4) chronic heart failure, smokers, CABG (n = 48). Comparisons were made with age- and gender-matched patients with a history of coronary disease but no LV dysfunction or smoking history (control subjects, n = 112) and to age-predicted norms. Results: Relative to control subjects and percent-predicted values, all groups with chronic heart failure had reduced lung volumes (total lung capacity [TLC] and vital capacity [VC]) and expiratory flows (p < 0.05). CABG had no influence on lung volumes and expiratory flows in smokers, but resulted in a tendency toward a reduced TLC and VC in nonsmokers. Smokers with chronic heart failure had reduced expiratory flows compared to nonsmokers (p < 0.05), indicating an additive effect of smoking. Diffusion capacity of the lung for carbon monoxide (DLCO) was reduced in smokers and in subjects who underwent CABG, but not in patients with chronic heart failure alone. There was no relationship between LV size and pulmonary function in this population, although LV function (cardiac index and stroke volume) was weakly associated with lung volumes and DLCO. Conclusions: We conclude that patients with chronic heart failure have primarily restrictive lung changes with smoking causing a further reduction in expiratory flows.",
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