title: Gender influences the relationship between lung function and cardiac remodeling in hypertensive subjects.
abstract: Hypertensive patients are predisposed to left ventricular (LV) remodeling and frequently exhibit decline in lung function as compared with the general population. Here, we investigated the association between spirometric and echocardiographic data in non-smoking hypertensive subjects and the role of gender in this regard. In a cross-sectional study, 107 hypertensive patients (60 women) enrolled from a university outpatient clinic were evaluated by clinical, hemodynamic, laboratory and echocardiographic analysis. Vital capacity, forced vital capacity (FVC), forced expired volume in 1 s (FEV1) and in 6 s (FEV6), FEV1/FVC ratio and FEV1/FEV6 ratio were estimated by spirometry. In women, higher LV mass index and E/Em ratio correlated with markers of restrictive lung alterations, such as reduced FVC (r=-044; P<0.001; r=-0.42; P<0.001, respectively) and FEV6 (r=-0.43; P<0.001; r=-0.39; P<0.01, respectively), while higher left atrial volume index correlated with markers of obstructive lung alterations, such as reduced FEV1/FVC (r=-055; P<0.001) and FEV1/FEV6 (r=-0.45; P<0.001) ratios. These relationships were further confirmed by stepwise regression analysis adjusted for potential confounders. In men, LV mass index correlated with FVC and FEV6, but these associations did not remain statistically significant after adjustment for confounding variables. Furthermore, inflammatory markers such as plasma C-reactive protein and matrix-metalloproteinases-2 and -9 levels did not influence the association between spirometric and cardiac parameters. In conclusion, these results indicate that LV remodeling is related to restrictive lung alterations while left atrial remodeling is associated with obstructive lung alterations in hypertensive women.
authors.affiliation: Department of Internal Medicine, School of Medical Sciences, University of Campinas, São Paulo, Brazil.
authors.forename: Paulo R
authors.initials: PR
authors.lastname: Mendes
authors.affiliation: Department of Internal Medicine, School of Medical Sciences, University of Campinas, São Paulo, Brazil.
authors.forename: Tatiana A
authors.initials: TA
authors.lastname: Kiyota
authors.affiliation: Department of Internal Medicine, School of Medical Sciences, University of Campinas, São Paulo, Brazil.
authors.forename: José A
authors.initials: JA
authors.lastname: Cipolli
authors.affiliation: Department of Internal Medicine, School of Medical Sciences, University of Campinas, São Paulo, Brazil.
authors.forename: Roberto
authors.initials: R
authors.lastname: Schreiber
authors.affiliation: Department of Internal Medicine, School of Medical Sciences, University of Campinas, São Paulo, Brazil.
authors.forename: Layde R
authors.initials: LR
authors.lastname: Paim
authors.affiliation: Department of Internal Medicine, School of Medical Sciences, University of Campinas, São Paulo, Brazil.
authors.forename: Vera R
authors.initials: VR
authors.lastname: Bellinazzi
authors.affiliation: Department of Internal Medicine, School of Medical Sciences, University of Campinas, São Paulo, Brazil.
authors.forename: José R
authors.initials: JR
authors.lastname: Matos-Souza
authors.affiliation: Department of Internal Medicine, School of Medical Sciences, University of Campinas, São Paulo, Brazil.
authors.forename: Andrei C
authors.initials: AC
authors.lastname: Sposito
authors.affiliation: Department of Internal Medicine, School of Medical Sciences, University of Campinas, São Paulo, Brazil.
authors.forename: Wilson
authors.initials: W
authors.lastname: Nadruz
mesh_terms: D000328:Adult; D000368:Aged; D016279:Atrial Function, Left; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012727:Sex Characteristics; D013147:Spirometry; D020257:Ventricular Remodeling; D014797:Vital Capacity