Author + information
- Wei Ming Huanga,b,
- Hao-Min Chenga,b,
- Tsu-Hui Shiaoa,b,
- Chen-Huan Chena,b,
- Wen-Chung Yua,b and
- Shih-Hsien Sunga,b
Background: The prevalence and prognostic value of chronic obstructive pulmonary disease (COPD) as a comorbidity in chronic heart failure (CHF) have been well documented. However, the role of pulmonary function indices in heart failure with preserved ejection fraction (HFpEF) subjects, with or without COPD, remains to be elucidated.
Methods: From August 2005 to December 2012, a total of 2068 subjects with CHF underwent pulmonary function tests. Total lung capacity (TLC), residual volume (RV), forced expiratory flow (FEF), forced expiratory volume in 1st second (FEV1), and forced vital capacity (FVC) were measured, as well as echocardiographic indices, including pulmonary artery systolic pressure (PASP), the ratio of early ventricular filling flow velocity (E) to the septal mitral annulus tissue velocity (e’) (E/e’), and left ventricular mass (LVM). National Death Registry was linked for the identifications of mortality.
Results: A total of 1194 patients (age 72.4 ± 13.2 years, 59% men) with HFpEF were included in this analysis, 182 patients died during a mean follow-up duration of 23.0 ± 12.8 months. Comparing to those without COPD, subjects with COPD were older, more likely to be men and have atrial fibrillation, higher TLC, RV/TLC ratio but lower FEF 25 to 75%, FEV1 and FEV1/FVC ratio. Both the restrictive (VC, FVC, and TLC) and obstructive (FEV1 and FEF 25 to 75%) indices correlated with PASP, E/e’, and LVM in stepwise linear regression model. In patients without COPD, the multivariable Cox proportional hazard models demonstrated VC, FVC, RV/TLC, and FEV1 were all associated with long-term all-cause mortality, after accounting for age, gender, eGFR, hemoglobin and PASP. In contrast, FEF 25 to 75% was the only independent predictor in subjects with HFpEF and COPD.
Conclusions: The pulmonary function measures were correlated with all-cause mortality both in the HFpEF patients with or without COPD. In addition, the association between lung function indices and hemodynamic measures may suggest the distinct pathophysiology of HFpEF involving the remodeling of pulmonary vasculature, interstitial change, and airway obstruction.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Emerging Developments in HFpEF and Arryhthmias
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1250-265
- 2017 American College of Cardiology Foundation