Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine

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 (FEV1), diffusing capacity of the lungs for carbon monoxide (DLCO), 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 FEV1 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 DLCO 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.