Johansson Sara, Sandin Petra, Lindgren Lenita, Mills Nicholas L, Hedman Linnea, Backman Helena, Nilsson Ulf
Department of Nursing, Umeå University, Umeå, Sweden.
BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
Eur Clin Respir J. 2024 Dec 10;12(1):2436203. doi: 10.1080/20018525.2024.2436203. eCollection 2025.
Individuals with a restrictive spirometric pattern have a high burden of cardiovascular and metabolic morbidity.
To assess prevalence of elevated cardiac biomarkers among individuals with a restrictive spirometric pattern compared to those with a normal lung function and to evaluate the association between cardiac biomarkers and mortality.
In 2002-04, individuals with airway obstruction were identified from population-based cohorts, together with age- and sex-matched non-obstructive referents. The analysis population consisted of the non-obstructive referents stratified according to whether they had a restrictive spirometric pattern or normal lung function in whom cardiac biomarkers were measured. Deaths were recorded until 31 December 2010.
Participants with a restrictive spirometric pattern were older and more likely to be obese with a higher burden of cardiovascular risk factors than those with normal function. Elevated cardiac troponin but not natriuretic peptide levels were more common in those with a restrictive spirometric pattern independent of age, sex, BMI, or risk factors (adjusted OR 1.8, 95% CI 1.29-2.74). At 5 years, death occurred more frequently in participants with restrictive spirometric pattern compared to those with normal function (15.7% [31/197] versus 7.6% [57/751]), with highest mortality rate in those with restriction and elevated cardiac troponin (28.7% [27/94]). Cardiac troponin was independently associated with death among those with a restrictive spirometric pattern (HR 4.91, 95% CI 1.58-15.26) but not in those with normal lung function.
Cardiac troponin was elevated more often in people with a restrictive spirometric pattern in whom it was a strong independent predictor of death.
具有限制性肺量计模式的个体心血管和代谢疾病负担较高。
评估与肺功能正常者相比，具有限制性肺量计模式的个体中心脏生物标志物升高的患病率，并评估心脏生物标志物与死亡率之间的关联。
在2002 - 2004年，从基于人群的队列中识别出气道阻塞个体，以及年龄和性别匹配的非阻塞对照者。分析人群包括根据是否具有限制性肺量计模式或正常肺功能分层的非阻塞对照者，对其进行心脏生物标志物测量。记录直至2010年12月31日的死亡情况。
与肺功能正常者相比，具有限制性肺量计模式的参与者年龄更大，更易肥胖，心血管危险因素负担更高。独立于年龄、性别、体重指数或危险因素，具有限制性肺量计模式的个体中心脏肌钙蛋白升高但利钠肽水平不升高更为常见（校正比值比1.8，95%可信区间1.29 - 2.74）。5年后，与肺功能正常者相比，具有限制性肺量计模式的参与者死亡更频繁（15.7% [31/197] 对 7.6% [57/751]），在具有限制性模式且心脏肌钙蛋白升高的个体中死亡率最高（28.7% [27/94]）。在具有限制性肺量计模式的个体中，心脏肌钙蛋白与死亡独立相关（风险比4.91，95%可信区间1.58 - 15.26），但在肺功能正常者中并非如此。
在具有限制性肺量计模式且心脏肌钙蛋白是死亡的强独立预测因子的人群中，心脏肌钙蛋白升高更为常见。
