title: Reduced forced expiratory volume is associated with increased incidence of atrial fibrillation: the Malmo Preventive Project.
abstract: OBJECTIVE
  Reduced forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) have been associated with increased incidence of cardiovascular diseases. However, whether reduced lung function is also a risk factor for incidence of atrial fibrillation (AF) is still unclear. We aimed to determine whether lung function predicted AF in the Malmö Preventive Project, a large population-based cohort with a long follow-up.
  
  
  RESULTS
  The study population consisted of 7674 women and 21 070 men, mean age 44.6 years. The cohort was followed on average for 24.8 years, during which time 2669 patients were hospitalized due to AF. The incidence of AF in relationship to quartiles of FEV1 and FVC and per litre decrease at baseline was determined using a Cox proportional hazards model adjusted for age, height, weight, current smoking status, systolic blood pressure, erythrocyte sedimentation rate, and fasting blood glucose. Forced expiratory volume in one second was inversely related to incidence of AF (per litre reduction in FEV1) hazard ratio (HR): 1.39 [95% confidence interval (CI): 1.16-1.68; P = 0.001] for women, and HR: 1.20 (95% CI: 1.13-1.29; P < 0.0001) for men. Forced vital capacity was also inversely related to incidence of AF (per litre reduction in FVC) HR: 1.20 (95% CI: 1.03-1.41; P = 0.020) for women, and HR: 1.08 (95% CI: 1.02-1.14; P = 0.01) for men. This relationship was consistent in non-smokers as well as smokers, and among individuals younger than the median age of 45.8 years or normotensive subjects.
  
  
  CONCLUSIONS
  Impaired lung function is an independent predictor of AF. This may explain some risk of AF that is currently unaccounted for.
authors: Department of Clinical Sciences, Lund University, Skåne University Hospital, Inga-Marie Nilssons väg 49, S-20502 Malmö, Sweden.
authors: Linda S B
authors: LS
authors: Johnson
authors: Tord
authors: T
authors: Juhlin
authors: Gunnar
authors: G
authors: Engström
authors: Peter M
authors: PM
authors: Nilsson
mesh_terms: D000328:Adult; D000367:Age Factors; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D014797:Vital Capacity
keywords: Atrial fibrillation; Glucose; Hypertension; Lung function; Population; Spirometry