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RESEARCH PRODUCT

Abstract 13257: FEV1 and FVC predict Mortality in Individuals Without Manifest Lung Disease Independent of Cardiac Performance - Results From the Population-based Gutenberg Health Study

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Background: Pulmonary disease has consistently been related to increased mortality. We investigated central spirometry variables in relation to total mortality in individuals from the general population without diagnosed lung disease also accounting for cardiac function. Methods: In 15,010 individuals from the general population (mean age 55±11 years, age range 35-74 years, 50.5% men) in the Gutenberg Health Study we performed spirometry and multimodal transthoracic echocardiography. The biomarkers N-terminal pro-B-type natriuretic peptide (Nt-proBNP) and high-sensitive troponin I (TnI) were measured in the first 5000 individuals using commercially available assays. Multivariable Cox regression analyses were computed for the lung function parameters forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and the Tiffeneau-Pinelli index (FEV1/FVC ratio) after exclusion of individuals with prevalent pulmonary disease (N=1135). Results: The median FEV1/FVC ratio was 79.1%, 19.5% were current smokers, 4.2% had prevalent heart failure. After a median follow-up of 5.5 years 360 deaths were recorded. Multivariable-adjusted Cox regression analyses for the common cardiovascular risk factors (age, sex, body mass index, current smoking, diabetes mellitus, hypertension, dyslipidemia) and heart failure revealed that an increase of one standard deviation (SD) of FEV1 was associated with a 38% risk reduction (hazard ratio (HR) per SD 0.62 [95% confidence interval (CI): 0.52-0.73]). The association remained statistically highly significant after additional adjustment for ejection fraction, stroke volume, Nt-proBNP or TnI. Comparable results were seen for FVC, whereas no association of FEV1/FVC ratio with mortality could be shown. No significant interaction by heart failure was observed. Conclusions: The central lung function parameters FEV1 and FVC were related to all-cause mortality in individuals without manifest lung disease. Our findings indicate that subtle, subclinical pulmonary impairment constitutes a risk for increased mortality independent of cardiac performance.