Abstract 17219: Prognostic Impact of Pulmonary Function in Systolic Heart Failure
Background: Dyspnea is a leading symptom of systolic heart failure (SHF) but little is known about pulmonary function in SHF. We investigated the prevalence and prognostic impact of pulmonary function pathologies in patients with SHF.
Methods: Pulmonary function testing (PFT) was performed in 625 patients six months after hospitalization for SHF. Central airways obstruction (CAO) was diagnosed if forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC) <0.7. Small airways obstruction (SAO) was assumed if FEV1/FVC ≥0.7 and maximum expiratory flow at 50% FVC was ≤70% of the predicted value. Restrictive ventilatory disorder (RVD) was assumed if total lung capacity was ≤90% of the predicted value. Combined pulmonary disorder was assumed if RVD and CAO or RVD and SAO were concomitantly present.
Results: Pulmonary function was normal in only 192 patients of the total cohort (31%). Obstructive ventilatory disorders, i.e. SAO or CAO were found in 117 and 73 subjects (12% and 19%), respectively (p<0.001). RVD was detected in 124 patients (20%). In 119 of 625 patients (19%), combined pulmonary disorder was demonstrated. During a median follow-up time of 34 months after PFT, 165 patients had died (26%). Obstructive and combined pulmonary disorders increased the risk of all-cause mortality (Figure). In combined disorders, this risk increase was independent of heart failure severity and smoking: hazard ratios were 1.94 (95% CI 1.18-3.22), p=0.01 and 2.29 (95%CI 1.10-4.76), p=0.026 for RVD&CAO and RVD&SAO, respectively.
Conclusions: A variety of pulmonary function pathologies occur in SHF. Combined respiratory limitations confer a particularly high mortality risk.
- © 2012 by American Heart Association, Inc.