Prognostic value of resting pulmonary function in heart failure

Background: The heart and lungs are intimately linked anatomically and physiologically, and, as a result, heart failure (HF) patients often develop changes in pulmonary function. This study examined the prognostic value of resting pulmonary function (PF) in HF. Methods and results: In all, 134 HF patients (enrolled from January 1, 1999 Through December 31, 2005; ejection fraction (EF) = 29% ± 11%; mean age = 55 ± 12 years; 65% male) were followed for 67 ± 34 months with death/transplant confirmed via the Social Security Index and Mayo Clinic registry. PF included forced vital capacity (FVC), forced expiratory volume in 1 second (FEV₁), diffusing capacity of the lungs for carbon monoxide (DL_CO), and alveolar volume (VA). Patients were divided in tertiles according to PF with survival analysis via log-rank Mantel-Cox test with chi-square analysis. Groups for FVC included (1)96%, (2) 96% to 81%, and (3), 81% predicted (chi-square = 18.9, P, 0.001). Bonferroni correction for multiple comparisons (BC) suggested differences between groups 1 and 3 (P, 0.001) and 2 and 3 (P = 0.008). Groups for FEV₁ included (1).94%, (2) 94% to 77%, and (3), 77% predicted (chi-square = 17.3, P, 0.001). BC suggested differences between groups 1 and 3 (P, 0.001). Groups for DL_CO included (1).90%, (2) 90% to 75%, and (3), 75% predicted (chi-square = 11.9, P = 0.003). BC suggested differences between groups 1 and 3 (P, 0.001). Groups for VA included (1).97%, (2) 97% to 87%, and (3), 87% predicted (Chi-square = 8.5, P = 0.01). BC suggested differences between groups 1 and 2 (P = 0.014) and 1 and 3 (P = 0.003). Conclusions: In a well-defined cohort of HF patients, resting measures of PF are predictive of all-cause mortality.