title: Lung function and airway obstruction: associations with circulating markers of cardiac function and incident heart failure in older men-the British Regional Heart Study.
abstract: The association between lung function and cardiac markers and heart failure (HF) has been little studied in the general older population. We have examined the association between lung function and airway obstruction with cardiac markers N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin T (cTnT) and risk of incident HF in older men.
  
  
  
  Prospective study of 3242 men aged 60-79 years without prevalent HF or myocardial infarction followed up for an average period of 13 years, in whom 211 incident HF cases occurred. Incident HF was examined in relation to % predicted FEV1 and FVC. The Global Initiative on Obstructive Lung Diseases spirometry criteria were used to define airway obstruction. Reduced FEV1, but not FVC in the normal range, was significantly associated with increased risk of HF after adjustment for established HF risk factors including inflammation. The adjusted HRs comparing men in the 6-24th percentile with the highest quartile were 1.91 (1.24 to 2.94) and 1.30 (0.86 to 1.96) for FEV1 and FVC, respectively. FEV1 and FVC were inversely associated with NT-proBNP and cTnT, although the association between FEV1 and incident HF remained after adjustment for NT-proBNP and cTnT. Compared with normal subjects (FEV1/FVC ≥0.70 and FVC≥80%), moderate or severe (FEV1/FVC <0.70 and FEV1 <80%) airflow obstruction was independently associated with HF ((adjusted relative risk 1.59 (1.08 to 2.33)). Airflow restriction (FEV1/FVC ≥0.70 and FVC <80%) was not independently associated with HF.
  
  
  
  Reduced FEV1 reflecting airflow obstruction is associated with cardiac dysfunction and increased risk of incident HF in older men.
authors.affiliation: Department of Primary Care and Population Health, University College London, London, UK.
authors.forename: S Goya
authors.initials: SG
authors.lastname: Wannamethee
authors.affiliation: Department of Primary Care and Population Health, University College London, London, UK.
authors.forename: A Gerald
authors.initials: AG
authors.lastname: Shaper
authors.affiliation: Department of Primary Care and Population Health, University College London, London, UK.
authors.forename: Olia
authors.initials: O
authors.lastname: Papacosta
authors.affiliation: Department of Primary Care and Population Health, University College London, London, UK.
authors.forename: Lucy
authors.initials: L
authors.lastname: Lennon
authors.affiliation: Institute of Cardiovascular & Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Welsh
authors.affiliation: Division of Population Health Sciences and Education, Population Health Research Centre, St George's University of London, London, UK.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Whincup
mesh_terms: D000368:Aged; D000402:Airway Obstruction / Q000097:blood* / Q000401:mortality / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood*; D004562:Electrocardiography; D004739:England / Q000453:epidemiology; D006333:Heart Failure / Q000097:blood* / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012129:Respiratory Function Tests; D011795:Surveys and Questionnaires; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: COPD epidemiology; Clinical Epidemiology
references.citation: Eur Respir J. 2004 Mar;23(3):456-63
references.pmid: 15065839
references.citation: Chest. 2007 Feb;131(2):349-55
references.pmid: 17296632
references.citation: J Am Geriatr Soc. 2009 Nov;57(11):2107-11
references.pmid: 19793355
references.citation: Am J Med. 2011 Apr;124(4):334-41
references.pmid: 21435424
references.citation: Am J Respir Crit Care Med. 2013 Nov 1;188(9):1091-9
references.pmid: 24033321
references.citation: JAMA. 2010 Dec 8;304(22):2494-502
references.pmid: 21078811
references.citation: Eur J Heart Fail. 2012 Apr;14(4):414-22
references.pmid: 22366234
references.citation: J Card Fail. 2005 Jun;11(5 Suppl):S81-3
references.pmid: 15948107
references.citation: Chest. 1995 Jan;107(1):28-35
references.pmid: 7813294
references.citation: Circulation. 2002 Apr 16;105(15):1785-90
references.pmid: 11956120
references.citation: Chest. 2013 Oct;144(4):1163-78
references.pmid: 23722528
references.citation: Eur Heart J. 2014 Feb;35(7):442-7
references.pmid: 24142349
references.citation: Eur Heart J. 2012 Jul;33(14):1787-847
references.pmid: 22611136
references.citation: J Am Coll Cardiol. 2000 May;35(6):1628-37
references.pmid: 10807470
references.citation: JAMA. 2010 Dec 8;304(22):2503-12
references.pmid: 21139111
references.citation: J Am Coll Cardiol. 2009 Feb 3;53(5):458; author reply 458-9
references.pmid: 19179209
references.citation: Circulation. 2014 Mar 4;129(9):971-80
references.pmid: 24344084
references.citation: Respiration. 2010;79(5):355-62
references.pmid: 20016119
references.citation: Thorax. 2004 Jul;59(7):574-80
references.pmid: 15223864
references.citation: Eur J Heart Fail. 2014 Jan;16(1):25-32
references.pmid: 23901058
references.citation: Chest. 2013 Mar;143(3):798-807
references.pmid: 23460157
references.citation: Heart. 2013 Mar;99(6):382-7
references.pmid: 23315609
references.citation: Circulation. 2013 Apr 9;127(14):1503-11, 1511e1-6
references.pmid: 23493320
references.citation: Respir Care. 2001 Aug;46(8):798-825
references.pmid: 11463370
references.citation: Eur Heart J. 2013 Sep;34(36):2795-803
references.pmid: 23832490
references.citation: Br Med J (Clin Res Ed). 1981 Jul 18;283(6285):179-86
references.pmid: 6789956
references.citation: Circulation. 1974 Jun;49(6):1160-6
references.pmid: 4275471
references.citation: Thorax. 2010 Jul;65(7):633-8
references.pmid: 20627923
references.citation: Int J Chron Obstruct Pulmon Dis. 2013;8:305-12
references.pmid: 23847414
references.citation: J Public Health Med. 2000 Dec;22(4):479-85
references.pmid: 11192275
references.citation: Circulation. 2011 Jul 5;124(1):24-30
references.pmid: 21670229
references.citation: Eur Heart J. 1989 Jul;10(7):647-56
references.pmid: 2788575
references.citation: Lung. 2012 Jun;190(3):271-6
references.pmid: 22246552
references.citation: Respir Res. 2012 Dec 13;13:115
references.pmid: 23237325
references.citation: J Am Coll Cardiol. 2011 Oct 25;58(18):1870-7
references.pmid: 22018297
references.citation: Chest. 2005 Jun;127(6):1952-9
references.pmid: 15947307
references.citation: Open Heart. 2015 Aug 11;2(1):e000266
references.pmid: 26290689