Honda Yuki, Watanabe Tetsu, Shibata Yoko, Otaki Yoichiro, Kadowaki Shinpei, Narumi Taro, Takahashi Tetsuya, Kinoshita Daisuke, Yokoyama Miyuki, Nishiyama Satoshi, Takahashi Hiroki, Arimoto Takanori, Shishido Tetsuro, Inoue Sumito, Miyamoto Takuya, Konta Tsuneo, Kawasaki Ryo, Daimon Makoto, Kato Takeo, Ueno Yoshiyuki, Kayama Takamasa, Kubota Isao
Department of Internal Medicine, National Insurance Kuzumaki Hospital, Iwate, Japan.
Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
Int J Cardiol. 2017 Aug 15;241:395-400. doi: 10.1016/j.ijcard.2017.04.049. Epub 2017 Apr 20.
Obstructive lung disorder (OLD) is known to be associated with cardiovascular disease. However, the impact of restrictive lung disorder (RLD) on cardiovascular mortality has not been fully investigated in the apparently healthy general population.
To clarify whether RLD is associated with cardiovascular mortality in the general population.
This community-based cohort study included 3247 subjects who participated in an annual health check in Takahata. We performed spirometry in registered subjects and found that 194 (6%) had RLD, 262 (8%) had OLD, and 73 (2%) had RLD and OLD (Mixed). During a 10-year follow-up, there were 210 deaths, including 57 cardiovascular deaths. Cardiovascular mortality of subjects with RLD was significantly higher than that of subjects with normal lung function. Although the subjects with RLD were younger, comprised fewer smokers, and were more likely to be female than those with OLD, cardiovascular mortality of subjects with RLD was comparable to that of subjects with OLD. Subjects with RLD had a higher prevalence of atrial fibrillation (AF) than those with OLD, and the prevalence of AF was increased with advanced severity of RLD. Multivariate Cox proportional hazard analysis revealed that RLD was an independent predictor of cardiovascular death (hazard ratio 2.61, 95% confidence interval, 1.22-5.21) after adjustment for confounders, but OLD was not. The net reclassification improvement and integrated discrimination improvement were significantly increased by the addition of RLD to conventional cardiovascular risk factors.
The presence of RLD was associated with cardiovascular mortality in the general population.
已知阻塞性肺疾病（OLD）与心血管疾病相关。然而，在看似健康的普通人群中，限制性肺疾病（RLD）对心血管死亡率的影响尚未得到充分研究。
阐明普通人群中RLD是否与心血管死亡率相关。
这项基于社区的队列研究纳入了3247名在高幡参加年度健康检查的受试者。我们对登记的受试者进行了肺活量测定，发现194人（6%）患有RLD，262人（8%）患有OLD，73人（2%）同时患有RLD和OLD（混合型）。在10年的随访期间，共有210人死亡，其中包括57例心血管死亡。RLD受试者的心血管死亡率显著高于肺功能正常的受试者。尽管RLD受试者比OLD受试者更年轻、吸烟者更少且女性比例更高，但RLD受试者的心血管死亡率与OLD受试者相当。RLD受试者的心房颤动（AF）患病率高于OLD受试者，且AF患病率随RLD严重程度的增加而升高。多因素Cox比例风险分析显示，在调整混杂因素后，RLD是心血管死亡的独立预测因素（风险比2.61，95%置信区间1.22 - 5.21），而OLD不是。将RLD添加到传统心血管危险因素中后，净重新分类改善和综合判别改善显著增加。
普通人群中RLD的存在与心血管死亡率相关。
