期刊
EUROPEAN HEART JOURNAL
卷 43, 期 23, 页码 2196-2208出版社
OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/ehac205
关键词
Spirometry; Lung function; Heart failure; Prospective cohort study
资金
- National Heart, Lung, and Blood Institute Pooled Cohorts Study
- National Heart, Lung, and Blood Institute
- National Institutes of Health [R01-HL-077612, R01-HL-093081, RC1-HL-100543, N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, N01-HC-95169]
- National Heart, Lung, and Blood Institute, National Institutes of Health
- Department of Health and Human Services [HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700005I, HHSN268201700004I]
- National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health [R01DK089174]
- CARDIA (Coronary Artery Risk Development in Young Adults) Study: CARDIA [HHSN268201800003I, HHSN268201800004I, HHSN268201800005I, HHSN268201800006I, HHSN268201800007I]
- Intramural Research Program of the National Institute on Aging
- National Institute on Aging [N01-AG-6-2101, N01-AG-6-2103, N01-AG-6-2106, R01-AG028050]
- National Heart, Lung, and Blood Institute grant [R01 HL122477, HHSN268201200036C, HHSN268200800007C, HHSN268201800001C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, U01HL080295, U01HL130114]
- National Institute of Neurological Disorders and Stroke
- FHS (Framingham Heart Study): From the Framingham Heart Study of the National Heart, Lung, and Blood Institute of the National Institutes of Health and Boston University School of Medicine
- National Heart, Lung, and Blood Institute's Framingham Heart Study [N01-HC-25195, HHSN268201500001I]
- Health ABC (Health Aging and Body Composition)
- National Institute of Nursing Research [R01-NR012459, HHSN268201800013I]
- Tougaloo College [HHSN268201800014I]
- Mississippi State Department of Health [HHSN268201800015I]
- University of Mississippi Medical Center [HHSN268201800010I, HHSN268201800011I, HHSN268201800012I]
- National Institute on Minority Health and Health Disparities
- MESA (Multi-Ethnic Study of Atherosclerosis)
- National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services [75N92019D00027, 75N92019D00028, 75N92019D00029, 75N92019D00030, R01HL109315, R01HL109301, R01HL109284, R01HL109282, R01HL109319, U01HL41642, U01HL41652, U01HL41654, U01HL65520, U01HL65521, TL1TR001875]
- US National Heart, Lung, and Blood Institute [U54 HL160273 R01 HL107577, R01 HL140731, R01 HL149423]
- Intramural Research Program of the NIH, National Institute of Environmental Health Sciences
The study found that lung function impairment was associated with an increased risk of incident heart failure, particularly in relation to HFpEF. This association was independent and of a similar magnitude to major cardiovascular risk factors.
Aims The aim is to evaluate associations of lung function impairment with risk of incident heart failure (HF). Methods and results Data were pooled across eight US population-based cohorts that enrolled participants from 1987 to 2004. Participants with self-reported baseline cardiovascular disease were excluded. Spirometry was used to define obstructive [forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) <0.70] or restrictive (FEV1/FVC >= 0.70, FVC <80%) lung physiology. The incident HF was defined as hospitalization or death caused by HF. In a sub-set, HF events were sub-classified as HF with reduced ejection fraction (HFrEF; EF <50%) or preserved EF (HFpEF; EF >= 50%). The Fine-Gray proportional sub-distribution hazards models were adjusted for sociodemographic factors, smoking, and cardiovascular risk factors. In models of incident HF sub-types, HFrEF, HFpEF, and non-HF mortality were treated as competing risks. Among 31 677 adults, there were 3344 incident HF events over a median follow-up of 21.0 years. Of 2066 classifiable HF events, 1030 were classified as HFrEF and 1036 as HFpEF. Obstructive [adjusted hazard ratio (HR) 1.17, 95% confidence interval (CI) 1.07-1.27] and restrictive physiology (adjusted HR 1.43, 95% CI 1.27-1.62) were associated with incident HF. Obstructive and restrictive ventilatory defects were associated with HFpEF but not HFrEF. The magnitude of the association between restrictive physiology and HFpEF was similar to associations with hypertension, diabetes, and smoking. Conclusion Lung function impairment was associated with increased risk of incident HF, and particularly incident HFpEF, independent of and to a similar extent as major known cardiovascular risk factors.
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