The prognostic importance of lung function in patients admitted with heart failure

The purpose of the present study was to determine the prognostic importance for all-cause mortality of lung function variables obtained by spirometry in an unselected group of patients admitted with heart failure (HF). This was a prospective prognostic study performed as part of the EchoCardiography and Heart Outcome Study (ECHOS). This analysis included 532 patients admitted with a clinical diagnosis of HF. All patients underwent spirometry and echocardiography and the diagnosis of HF was made according to established criteria. Mean forced expiratory volume in 1 s (FEV1) was 65% of the predicted value [95% confidence interval (CI) 63-67%], mean forced vital capacity (FVC) was 71% of predicted (95% CI 69-72%), and FEV1/FVC was 0.72 (95% CI 0.71-0.73). FEV1, FVC, and FEV1/FVC were all significant prognostic factors for all-cause mortality in univariate analyses. In a multivariate analysis, FEV1 had independent prognostic value (hazard ratio 0.86 per 10% change, P < 0.001) after adjusting for demographic variables, known risk factors, ejection fraction, and self-reported chronic obstructive pulmonary disease. Pulmonary function provides significant prognostic information for all-cause mortality in patients admitted with HF. Spirometry therefore seems to be worth considering for all patients admitted with HF in order to identify patients at high risk.