• Christina Magnussen, Francisco M Ojeda, Nargiz Rzayeva, Tanja Zeller, Christoph R Sinning, Norbert Pfeiffer, Manfred Beutel, Maria Blettner, Karl J Lackner, Stefan Blankenberg, Thomas Münzel, Klaus F Rabe, Philipp S Wild, Renate B Schnabel, and Gutenberg Health Study investigators.
• Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany. Electronic address: c.magnussen@uke.de.
• Int. J. Cardiol. 2017 May 1; 234: 64-68.

BackgroundLung function has previously been related to increased mortality. Whether pulmonary impairment is associated with an increased mortality independent of cardiac dysfunction remains unclear.MethodsIn 15010 individuals from the general population (age range 35-74years, 51% men) in the Gutenberg Health Study we performed spirometry and transthoracic echocardiography. N-terminal pro-B-type natriuretic peptide (Nt-proBNP) and high-sensitive troponin I (hsTnI) were measured in all individuals. 1819 individuals with pulmonary diseases were excluded from further analysis.ResultsThe median for forced expiratory volume in 1s (FEV1) was 94.2% and for forced vital capacity (FVC) 94.2% as a percentage of their predicted values. The median FEV1/FVC ratio was 79.1%. In 13191 subjects, 335 deaths were verified from death certificate over a median follow-up of 5.5years. Multivariable-adjusted Cox regression analyses for common cardiovascular risk factors and heart failure revealed that an increase of one standard deviation (SD) of percent predicted (%pred.) FEV1 was associated with a 22% risk reduction (hazard ratio [HR] per SD 0.78 [95% confidence interval (CI): 0.70, 0.86]). The association remained statistically significant after additional adjustment for diastolic dysfunction, Nt-proBNP or hsTnI. Comparable results were seen for %pred. FVC. After adjustment, no association of FEV1/FVC ratio with mortality could be shown. No significant interaction by heart failure was observed.ConclusionsThe lung function parameters FEV1 and FVC, but not FEV1/FVC ratio, were related to all-cause mortality in individuals from the general population independent of cardiac function.Copyright © 2017 Elsevier B.V. All rights reserved.

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