Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
Int J Med Sci. 2011;8(7):514-22. doi: 10.7150/ijms.8.514. Epub 2011 Aug 29.
Chronic pulmonary disorders, such as chronic obstructive pulmonary disease (COPD) and fibrosing lung diseases, and atrial fibrillation (AF), are prevalent in elderly people. The impact of cardiac co-morbidities in the elderly, where pulmonary function is impaired, cannot be ignored as they influence mortality. The relationship between the prevalence of AF and pulmonary function is unclear. The aim of this study was to evaluate this relationship in participants in a health check.
Subjects aged 40 or older (n = 2,917) who participated in a community-based annual health check in Takahata, Japan, from 2004 through to 2005, were enrolled in the study. We performed blood pressure measurements, blood sampling, electrocardiograms, and spirometry on these subjects.
The mean FEV(1) % predicted and FVC % predicted in AF subjects was significantly lower than in non-AF subjects. The prevalence of AF was higher in those subjects with airflow limitation or lung restriction than in those without. Furthermore, AF prevalence was higher in those subjects with severe airflow obstruction (FEV(1) %predicted < 50) than in those who had mild or moderate airflow obstruction (FEV(1) %predicted ≥ 50), although there was no difference between the prevalence of AF in subjects with 70≤ FVC %predicted <80 lung restriction and those with FVC %predicted <70. Multiple logistic regression analysis revealed that FEV(1) %predicted and FVC %predicted are independent risk factors for AF (independent of age, gender, left ventricular hypertrophy, and serum levels of B-type natriuretic peptide).
Impaired pulmonary function is an independent risk factor for AF in the Japanese general population.
慢性肺部疾病,如慢性阻塞性肺疾病(COPD)和肺纤维化疾病,以及心房颤动(AF),在老年人中较为普遍。在老年人中,心脏合并症的影响不容忽视,因为它们会影响死亡率,而肺部功能受损的情况。心脏合并症与 AF 患病率之间的关系尚不清楚。本研究旨在评估参加健康检查的参与者中的这种关系。
我们招募了 2004 年至 2005 年期间在日本高畠市参加社区年度健康检查的年龄在 40 岁或以上(n = 2917)的受试者。我们对这些受试者进行了血压测量、采血、心电图和肺功能检查。
AF 受试者的 FEV1%预计值和 FVC%预计值明显低于非 AF 受试者。在存在气流受限或肺限制的受试者中,AF 的患病率高于无气流受限或肺限制的受试者。此外,在严重气流阻塞(FEV1%预测值<50)的受试者中,AF 的患病率高于轻度或中度气流阻塞(FEV1%预测值≥50)的受试者,尽管在 FVC%预测值为 70≤肺限制的受试者和 FVC%预测值<70 的受试者之间,AF 的患病率没有差异。多变量逻辑回归分析显示,FEV1%预测值和 FVC%预测值是 AF 的独立危险因素(独立于年龄、性别、左心室肥厚和血清 B 型利钠肽水平)。
在日本普通人群中,肺功能受损是 AF 的独立危险因素。