Department of Epidemiology, University of North Carolina, 137 E. Franklin Street, Chapel Hill, NC 27514, USA.
Eur J Heart Fail. 2012 Apr;14(4):414-22. doi: 10.1093/eurjhf/hfs016. Epub 2012 Feb 25.
We examined the relationship between forced expiratory volume in 1 s (FEV(1)), airflow obstruction, and incident heart failure (HF) in black and white, middle-aged men and women in four US communities.
Lung volumes by standardized spirometry and information on covariates were collected on 15 792 Atherosclerosis Risk in Communities (ARIC) cohort participants in 1987-89. Incident HF was ascertained from hospital records and death certificates up to 2005 in 13 660 eligible participants. Over an average follow-up of 14.9 years, 1369 (10%) participants developed new-onset HF. The age- and height-adjusted hazard ratios (HRs) for HF increased monotonically over descending quartiles of FEV(1) for both genders, race groups, and smoking status. After multivariable adjustment for traditional cardiovascular risk factors and height, the HRs [95% confidence intervals (CIs)] of HF comparing the lowest with the highest quartile of FEV(1) were 3.91 (2.40-6.35) for white women, 3.03 (2.12-4.33) for white men, 2.11 (1.33-3.34) for black women, and 2.23 (1.37-3.59) for black men. The association weakened but remained statistically significant after additional adjustment for systemic markers of inflammation. The multivariable adjusted incidence of HF was higher in those with FEV(1)/forced vital capacity <70% vs. ≥70%: HR 1.44 (95% CI 1.20-1.74) among men and 1.40 (1.13-1.72) among women. A consistent and positive association with HF was seen for self-reported diagnosis of emphysema and chronic obstructive pulmonary disease, but not for asthma.
In this large population-based cohort with long-term follow-up, low FEV(1) and an obstructive respiratory disease were strongly and independently associated with the risk of incident HF.
我们在四个美国社区的黑人和白人中年男女中，研究了 1 秒用力呼气量（FEV1）、气流阻塞与心力衰竭（HF）事件之间的关系。
在 1987-89 年的 15792 名动脉粥样硬化风险社区（ARIC）队列参与者中，通过标准化肺活量测定法收集了肺容量和协变量信息。在 13660 名符合条件的参与者中，通过医院记录和死亡证明确定了新发生的 HF。在平均 14.9 年的随访中，1369 名（10%）参与者发生了新的 HF。对于两性、种族群体和吸烟状况，HF 的年龄和身高调整后的风险比（HR）随着 FEV1 下降四分位数呈单调递增。在对传统心血管危险因素和身高进行多变量调整后，与 FEV1 最低四分位数相比，HF 的 HR（95%置信区间[CI]）分别为：白色女性 3.91（2.40-6.35），白色男性 3.03（2.12-4.33），黑色女性 2.11（1.33-3.34），黑色男性 2.23（1.37-3.59）。这种关联在进一步调整全身炎症标志物后减弱，但仍具有统计学意义。FEV1/用力肺活量<70%与≥70%相比，HF 的多变量调整后发病率更高：男性 HR 1.44（95%CI 1.20-1.74），女性 HR 1.40（1.13-1.72）。在男性和女性中，HF 与自我报告的肺气肿和慢性阻塞性肺疾病诊断呈一致性和正相关，但与哮喘无关。
在这项具有长期随访的大型基于人群的队列研究中，低 FEV1 和阻塞性呼吸道疾病与 HF 事件的风险密切相关。
