Abstract 17161: Reduced Ventilatory Function and Gas Exchange are Associated With Cardiac Remodeling and Changes in Systolic and Diastolic Function in the Community

Abstract

Introduction: Chronic lung disease and heart failure have been reported to be associated, but the pathophysiologic relations between cardiac and pulmonary structure and function in the community are not well understood. We evaluated cross-sectional associations between measures of pulmonary function and echocardiographic traits related to cardiac remodeling and systolic and diastolic function in a large, community-based sample. Hypothesis: We hypothesized that lower ventilatory function and diffusion capacity would be associated with adverse cardiac remodeling and reduced left ventricular (LV) systolic and diastolic function. Methods: Forced expiratory volume in 1 second (FEV1), single-breath carbon monoxide diffusion capacity (DLCO), and comprehensive echocardiographic measures were obtained in approximately 2500 participants (mean age 67±9 years; 55% women) attending the 8 th Framingham Offspring examination cycle. Results: Using multivariable-adjusted linear regression models, we observed lower DLCO to be associated with lower fractional shortening, relatively higher early LV filling (E/A ratio), greater LV filling pressures (E/e’ ratio), and smaller right ventricular (RV) size ( Table) . Similarly, lower FEV1 was associated with smaller left atrial size, relatively higher early LV filling (E/A ratio), smaller RV size, and smaller right atrial area ( Table ). Conclusions: Lower ventilatory function and diffusion capacity are associated with smaller cardiac chamber dimensions, worse LV systolic function, and changes in measures of LV diastolic filling. The mechanisms responsible for these relations require further investigation, but these associations provide evidence for a pathophysiologic association between chronic lung disease and abnormalities in cardiac structure and function in the community.