The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Eur J Heart Fail. 2010 Jul;12(7):685-91. doi: 10.1093/eurjhf/hfq050. Epub 2010 Apr 15.
The purpose of the present study was to determine the prognostic importance for all-cause mortality of lung function variables obtained by spirometry in an unselected group of patients admitted with heart failure (HF).
This was a prospective prognostic study performed as part of the EchoCardiography and Heart Outcome Study (ECHOS). This analysis included 532 patients admitted with a clinical diagnosis of HF. All patients underwent spirometry and echocardiography and the diagnosis of HF was made according to established criteria. Mean forced expiratory volume in 1 s (FEV(1)) was 65% of the predicted value [95% confidence interval (CI) 63-67%], mean forced vital capacity (FVC) was 71% of predicted (95% CI 69-72%), and FEV(1)/FVC was 0.72 (95% CI 0.71-0.73). FEV(1), FVC, and FEV(1)/FVC were all significant prognostic factors for all-cause mortality in univariate analyses. In a multivariate analysis, FEV(1) had independent prognostic value (hazard ratio 0.86 per 10% change, P < 0.001) after adjusting for demographic variables, known risk factors, ejection fraction, and self-reported chronic obstructive pulmonary disease.
Pulmonary function provides significant prognostic information for all-cause mortality in patients admitted with HF. Spirometry therefore seems to be worth considering for all patients admitted with HF in order to identify patients at high risk.
本研究旨在确定在因心力衰竭（HF）入院的未选择患者群体中，通过肺活量测定法获得的肺功能变量对全因死亡率的预后重要性。
这是一项前瞻性预后研究，作为超声心动图和心脏结局研究（ECHOS）的一部分进行。该分析包括 532 名因临床诊断为 HF 而入院的患者。所有患者均接受了肺活量测定和超声心动图检查，HF 的诊断符合既定标准。平均用力呼气 1 秒量（FEV1）为预计值的 65%[95%置信区间（CI）63-67%]，平均用力肺活量（FVC）为预计值的 71%（95%CI 69-72%），FEV1/FVC 为 0.72（95%CI 0.71-0.73）。FEV1、FVC 和 FEV1/FVC 在单因素分析中均为全因死亡率的显著预后因素。在多变量分析中，FEV1 在调整人口统计学变量、已知危险因素、射血分数和自我报告的慢性阻塞性肺疾病后具有独立的预后价值（每 10%变化的危险比为 0.86，P<0.001）。
肺功能为因 HF 入院的患者的全因死亡率提供了重要的预后信息。因此，对于因 HF 入院的所有患者，肺活量测定似乎值得考虑，以识别高风险患者。
