title: Pulmonary hyperinflation and left ventricular mass: the Multi-Ethnic Study of Atherosclerosis COPD Study.
abstract: BACKGROUND
  Left ventricular (LV) mass is an important predictor of heart failure and cardiovascular mortality, yet determinants of LV mass are incompletely understood. Pulmonary hyperinflation in chronic obstructive pulmonary disease (COPD) may contribute to changes in intrathoracic pressure that increase LV wall stress. We therefore hypothesized that residual lung volume in COPD would be associated with greater LV mass.
  
  
  RESULTS
  The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Study recruited smokers 50 to 79 years of age who were free of clinical cardiovascular disease. LV mass was measured by cardiac magnetic resonance. Pulmonary function testing was performed according to guidelines. Regression models were used to adjust for age, sex, body size, blood pressure, and other cardiac risk factors. Among 119 MESA COPD Study participants, the mean age was 69±6 years, 55% were male, and 65% had COPD, mostly of mild or moderate severity. Mean LV mass was 128±34 g. Residual lung volume was independently associated with greater LV mass (7.2 g per 1-SD increase in residual volume; 95% confidence interval, 2.2-12; P=0.004) and was similar in magnitude to that of systolic blood pressure (7.6 g per 1-SD increase in systolic blood pressure; 95% confidence interval, 4.3-11; P<0.001). Similar results were observed for the ratio of LV mass to end-diastolic volume (P=0.02) and with hyperinflation measured as residual volume to total lung capacity ratio (P=0.009).
  
  
  CONCLUSIONS
  Pulmonary hyperinflation, as measured by residual lung volume or residual lung volume to total lung capacity ratio, is associated with greater LV mass.
authors.affiliation: Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Smith
authors.forename: Steven M
authors.initials: SM
authors.lastname: Kawut
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.forename: Robert C
authors.initials: RC
authors.lastname: Basner
authors.forename: Antoinette S
authors.initials: AS
authors.lastname: Gomes
authors.forename: Eric
authors.initials: E
authors.lastname: Hoffman
authors.forename: Ravi
authors.initials: R
authors.lastname: Kalhan
authors.forename: João A C
authors.initials: JA
authors.lastname: Lima
authors.forename: Chia-Ying
authors.initials: CY
authors.lastname: Liu
authors.forename: Erin D
authors.initials: ED
authors.lastname: Michos
authors.forename: Martin R
authors.initials: MR
authors.lastname: Prince
authors.forename: LeRoy
authors.initials: L
authors.lastname: Rabbani
authors.forename: Daniel
authors.initials: D
authors.lastname: Rabinowitz
authors.forename: Daichi
authors.initials: D
authors.lastname: Shimbo
authors.forename: Steven
authors.initials: S
authors.lastname: Shea
authors.forename: R Graham
authors.initials: RG
authors.lastname: Barr
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality; D004646:Emphysema / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010991:Plethysmography; D011237:Predictive Value of Tests; D011312:Pressure; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality; D012115:Residual Volume; D012307:Risk Factors; D012907:Smoking / Q000208:ethnology / Q000401:mortality; D014057:Tomography, X-Ray Computed; D014109:Total Lung Capacity