Vital capacity and congestive heart failure. The Framingham study.

Abstract

This report is concerned with an assessment of the utility of the vital capacity in anticipating the occurrence of congestive heart failure in susceptible persons before overt symptoms and signs. To this end, an examination of the relation of routinely measured biennial vital capacities to subsequent incidence of clinically overt myocardial decompensation over the next two years was undertaken. In 5209 persons so evaluated over an 18 year period it was found that risk of congestive heart failure varied over a 10-fold range in inverse proportion to their vital capacity (standardized for height) in persons still free of clinical evidence of myocardial decompensation. Also, among persons at high risk of failure (due to coronary disease, hypertension or rheumatic heart disease) chances of developing congestive failure were doubled in men with low vital capacities and tripled in women. Examination of the net contribution of vital capacity to risk of congestive failure revealed that a low vital capacity was associated with development of congestive failure even after taking into account other contributing factors including blood pressure, relative weight, pulse rate, cigarette smoking, heart enlargement on X-ray, ECG-LVH, blood glucose and age. Both a persistently low and a recent fall in vital capacity were associated with increased risk of congestive failure. Obstructive lung disease was not a factor in either case since FEV 1 /total vital capacity (TVC) was unrelated to congestive heart failure incidence. The simple total vital capacity thus appears to have considerable utility as a practical, noninvasive office procedure for evaluating failing left ventricular performance.