Abstract 13854: Association Between Pulmonary Function, Cardiac Structure and Function, and Cardiovascular Outcomes in the General Population

Abstract

Introduction: We investigated the association between the lung function and cardiac structure and function, and how the lung function affects the prognostic value of cardiac structure and function in the general population. Methods: All participants from the 4 th Copenhagen City Heart Study examination round who had an echocardiography and spirometry performed were included in the present analysis. Participants were classified as having either normal lung function with a forced expiratory volume in one second (FEV1) >=80% of expected or decreased lung function with FEV1<80%.The endpoint consisted of cardiovascular death, acute myocardial infarction, or incident heart failure. Results: Participants (n=2,149) were followed for a median 14.4 years (IQR 10.8-14.9), and there was a total of 371 (17%) events. The mean age was 57 ± 16 years, 57% were women, 44% had hypertension, and 64% were current or previous smokers. Decreased lung function at baseline was associated with a lower left ventricular ejection fraction (LVEF), a higher left ventricular mass index (LVMI), and a higher E/e’. In univariable analysis, LVEF, LVMI, E/e’, and left atrial volume (LAV) were predictors of the composite outcome in both groups. After multivariable adjustment for clinical and echocardiographic parameters, only LVMI remained an independent predictor of the composite outcome in both groups (normal lung function: HR 1.04, 95% CI (1.01-1.07), p=0.010; decreased lung function: HR 1.06, 95% CI (1.01-1.10), p=0.009). LVEF and LAV remained predictors of the composite outcome only in participants with normal lung function. Conclusions: In participants from the general population, a FEV1 below 80% was associated with a lower LVEF, a higher LVMI and a higher E/e’. For participants with normal lung function, LVEF, LVMI, and LAV were independent predictors of adverse cardiovascular events. For participants with a FEV1 below 80%, only LVMI was an independent predictor of adverse cardiovascular events.