Denzer, Dustin L

Pulmonary function (PF) may be influenced by a deterioration of cardiac function. As such, resting measures of PF may be prognostically useful in heart failure patients (HF). This study examined the prognostic value of resting PF in a cohort of HF. This included 113 patients (enrolled 1999‐2005, EF=28±11%; age=55±12yr; 62% male) followed for 64±34mo with death confirmed via the SSI & Mayo Clinic registry. PF included, forced vital capacity, FVC; diffusing capacity, DLCO; forced expiratory volume, FEV1; alveolar volume, VA. Patients were divided in tertiles according to PF with survival analysis via Log‐rank Mantel‐Cox Test with Chi squared analysis (Chi‐sq). Groups for FVC: 1)=80, 2)81‐97, 3)=98, %pre (Chi‐sq 21.5, p<0.01). Bonferonni correction (BC) suggested differences (diff) between groups 1 & 2 and 1 & 3 (p=0.01) with no diff (ND) between 2 & 3 (p=0.62). Groups for FEV1: 1)=77, 2)78‐95, 3)=96, %pre (Chi‐sq 16.3, p<0.01). BC suggested diff between groups 1 & 2 (p=0.02) and 1 & 3 (p<0.01). Groups for DLCO: 1)=75, 2)76‐90, 3)=91, %pre (Chi‐sq=8.2, p=0.02). BC suggested diff between groups 1 & 3 (p=0.003) with ND between 1 & 2 or 2 & 3 (p>0.05). Groups for VA: 1)=87, 2)88‐97, 3)=98, %pre (Chi‐sq=8.9, p=0.01). BC suggested diff between 1 & 3 (p<0.01) with ND between 1 & 2 or 2 & 3 (p>0.05). In a well defined cohort of HF patients, resting measures of PF appear to be predictive of all cause mortality. NIH HL71478

Background The heart and lungs are intimately linked anatomically and physiologically, and, as a result, heart failure (HF) patients often develop changes in pulmonary function. This study examined the prognostic value of resting pulmonary function (PF) in HF. Methods and Results In all, 134 HF patients (enrolled from January 1, 1999 Through December 31, 2005; ejection fraction (EF) = 29% ± 11%; mean age = 55 ± 12 years; 65% male) were followed for 67 ± 34 months with death/transplant confirmed via the Social Security Index and Mayo Clinic registry. PF included forced vital capacity (FVC), forced expiratory volume in 1 second (FEV 1 ), diffusing capacity of the lungs for carbon monoxide (DL CO ), and alveolar volume (VA). Patients were divided in tertiles according to PF with survival analysis via log-rank Mantel-Cox test with chi-square analysis. Groups for FVC included (1) >96%, (2) 96% to 81%, and (3) <81% predicted (chi-square = 18.9, P< 0.001). Bonferroni correction for multiple comparisons (BC) suggested differences between groups 1 and 3 (P < 0.001) and 2 and 3 ( P = 0.008). Groups for FEV 1 included (1) >94%, (2) 94% to 77%, and (3) <77% predicted (chi-square = 17.3, P < 0.001). BC suggested differences between groups 1 and 3 ( P < 0.001). Groups for DL CO included (1) >90%, (2) 90% to 75%, and (3) <75% predicted (chi-square = 11.9, P = 0.003). BC suggested differences between groups 1 and 3 >( P < 0.001). Groups for VA included (1) <97%, (2) 97% to 87%, and (3) <87% predicted (Chi-square = 8.5, P = 0.01). BC suggested differences between groups 1 and 2 ( P = 0.014) and 1 and 3 >( P = 0.003). Conclusions In a well-defined cohort of HF patients, resting measures of PF are predictive of all-cause mortality.