Restrictive Lung Function Is Related to Sympathetic Hyperactivity in Patients With Heart Failure.
BACKGROUND
Sympathoexcitation and impaired lung function are common in patients with severe heart failure (HF). However, the association between impaired lung function and sympathoexcitation remains unknown.


RESULTS
Muscle sympathetic nerve activity (MSNA) and clinical variables were determined in 83 HF patients with left ventricular ejection fraction (LVEF) <0.45. Restrictive and obstructive changes on spirometry were defined as reduced forced vital capacity (FVC) of <80% of predicted and a ratio of forced expiratory volume in the first second to FVC of <70%, respectively. Restrictive and obstructive changes were identified in 17 and 21 patients, respectively. MSNA was higher in patients with restrictive changes than in those without restrictive changes (84 vs 66 bursts per 100 beats; P < .01), but was similar in those with and without obstructive changes. Univariate analyses showed that FVC, estimated glomerular filtration rate (eGFR), specific activity scale, B-type natriuretic peptide level, LVEF, age, and use of aldosterone receptor blockers were significant predictors of MSNA burst incidence. Multivariate analysis revealed that FVC, LVEF, and eGFR were independent factors for increased burst incidence. Changes in FVC during follow-up negatively correlated with changes in burst rate (n = 11; P < .01).


CONCLUSIONS
Restrictive lung function was associated with increased sympathetic nerve activity independently from HF severity.
Second Department of Internal Medicine, Toyama University Hospital, Toyama, Japan. Electronic address: sjoho@med.u-toyama.ac.jp.
Shuji
S
Joho
Second Department of Internal Medicine, Toyama University Hospital, Toyama, Japan.
Ryuichi
R
Ushijima
Second Department of Internal Medicine, Toyama University Hospital, Toyama, Japan.
Takashi
T
Akabane
Second Department of Internal Medicine, Toyama University Hospital, Toyama, Japan.
Tadakazu
T
Hirai
Second Department of Internal Medicine, Toyama University Hospital, Toyama, Japan.
Hiroshi
H
Inoue
D000368:Aged; D000704:Analysis of Variance; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005541:Forced Expiratory Volume; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000453:epidemiology* / Q000503:physiopathology*; D006801:Humans; D008168:Lung / Q000294:innervation; D008171:Lung Diseases / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012016:Reference Values; D013147:Spirometry / Q000379:methods; D013318:Stroke Volume / Q000502:physiology*; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D014655:Vascular Resistance / Q000502:physiology*; D014797:Vital Capacity / Q000502:physiology
Heart failure; restrictive lung function; sympathetic nerve activity