title: Loss of Lung Health from Young Adulthood and Cardiac Phenotypes in Middle Age.
abstract: BACKGROUND
  Chronic lung diseases are associated with cardiovascular disease. How these associations evolve from young adulthood forward is unknown. Understanding the preclinical history of these associations could inform prevention strategies for common heart-lung conditions.
  
  
  OBJECTIVE
  To use the Coronary Artery Risk Development in Young Adults (CARDIA) study to explore the development of heart-lung interactions.
  
  
  METHODS
  We analyzed cardiac structural and functional measurements determined by echocardiography at Year 25 of CARDIA and measures of pulmonary function over 20 years in 3,000 participants.
  
  
  RESULTS
  Decline in FVC from peak was associated with larger left ventricular mass (β = 6.05 g per SD of FVC decline; P < 0.0001) and greater cardiac output (β = 0.109 L/min per SD of FVC decline; P = 0.001). Decline in FEV1/FVC ratio was associated with smaller left atrial internal dimension (β = -0.038 cm per SD FEV1/FVC decline; P < 0.0001) and lower cardiac output (β = -0.070 L/min per SD of FEV1/FVC decline; P = 0.03). Decline in FVC was associated with diastolic dysfunction (odds ratio, 3.39; 95% confidence interval, 1.37-8.36; P = 0.006).
  
  
  CONCLUSIONS
  Patterns of loss of lung health are associated with specific cardiovascular phenotypes in middle age. Decline in FEV1/FVC ratio is associated with underfilling of the left heart and low cardiac output. Decline in FVC with preserved FEV1/FVC ratio is associated with left ventricular hypertrophy and diastolic dysfunction. Cardiopulmonary interactions apparent with common complex heart and lung diseases evolve concurrently from early adulthood forward.
authors: 1 Division of Pulmonary and Critical Care Medicine.
authors: Michael J
authors: MJ
authors: Cuttica
authors: 2 Division of Cardiology, and.
authors: Laura A
authors: LA
authors: Colangelo
authors: 2 Division of Cardiology, and.
authors: Sanjiv J
authors: SJ
authors: Shah
authors: 3 Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland;
authors: Joao
authors: J
authors: Lima
authors: 3 Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland;
authors: Satoru
authors: S
authors: Kishi
authors: 4 Division of Preventive Medicine, University of Alabama, Birmingham, Alabama;
authors: Alexander
authors: A
authors: Arynchyn
authors: 5 Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota; and.
authors: David R
authors: DR
authors: Jacobs
authors: 6 Department of Laboratory Medicine and Pathology, University of Minnesota School of Medicine, Minneapolis, Minnesota.
authors: Bharat
authors: B
authors: Thyagarajan
authors: 7 Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois;
authors: Kiang
authors: K
authors: Liu
authors: 2 Division of Cardiology, and.|7 Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois;
authors: Donald
authors: D
authors: Lloyd-Jones
authors: 1 Division of Pulmonary and Critical Care Medicine.|7 Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois;
authors: Ravi
authors: R
authors: Kalhan
mesh_terms: D000328:Adult; D000375:Aging; D002318:Cardiovascular Diseases / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D005541:Forced Expiratory Volume; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000473:pathology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008168:Lung / Q000473:pathology / Q000503:physiopathology*; D008171:Lung Diseases / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D011446:Prospective Studies; D014463:Ultrasonography; D014797:Vital Capacity; D055815:Young Adult
keywords: echocardiography; epidemiology; lung; pulmonary heart disease