Pulmonary hyperinflation and left ventricular mass

The multi-ethnic study of atherosclerosis COPD study

Benjamin M. Smith, Steven M. Kawut, David A. Bluemke, Robert C. Basner, Antoinette S. Gomes, Eric Hoffman, Ravi Kalhan, João A.C. Lima, Chia Ying Liu, Erin D. Michos, Martin R. Prince, Leroy Rabbani, Daniel Rabinowitz, Daichi Shimbo, Steven Shea, R. Graham Barr*

*Corresponding author for this work

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Background-Left ventricular (LV) mass is an important predictor of heart failure and cardiovascular mortality, yet determinants of LV mass are incompletely understood. Pulmonary hyperinflation in chronic obstructive pulmonary disease (COPD) may contribute to changes in intrathoracic pressure that increase LV wall stress. We therefore hypothesized that residual lung volume in COPD would be associated with greater LV mass. Methods and Results-The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Study recruited smokers 50 to 79 years of age who were free of clinical cardiovascular disease. LV mass was measured by cardiac magnetic resonance. Pulmonary function testing was performed according to guidelines. Regression models were used to adjust for age, sex, body size, blood pressure, and other cardiac risk factors. Among 119 MESA COPD Study participants, the mean age was 69±6 years, 55% were male, and 65% had COPD, mostly of mild or moderate severity. Mean LV mass was 128±34 g. Residual lung volume was independently associated with greater LV mass (7.2 g per 1-SD increase in residual volume; 95% confidence interval, 2.2-12; P=0.004) and was similar in magnitude to that of systolic blood pressure (7.6 g per 1-SD increase in systolic blood pressure; 95% confidence interval, 4.3-11; P<0.001). Similar results were observed for the ratio of LV mass to end-diastolic volume (P=0.02) and with hyperinflation measured as residual volume to total lung capacity ratio (P=0.009). Conclusions-Pulmonary hyperinflation, as measured by residual lung volume or residual lung volume to total lung capacity ratio, is associated with greater LV mass.

Original languageEnglish (US)
Pages (from-to)1503-1511
Number of pages9
JournalCirculation
Volume127
Issue number14
DOIs
StatePublished - Apr 9 2013

Fingerprint

Residual Volume
Chronic Obstructive Pulmonary Disease
Atherosclerosis
Lung
Blood Pressure
Total Lung Capacity
Confidence Intervals
Body Size
Cardiovascular Diseases
Magnetic Resonance Spectroscopy
Heart Failure
Guidelines
Pressure
Mortality

Keywords

  • Chronic obstructive pulmonary disease
  • Hyperinflation
  • Left ventricular mass

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Smith, B. M., Kawut, S. M., Bluemke, D. A., Basner, R. C., Gomes, A. S., Hoffman, E., ... Barr, R. G. (2013). Pulmonary hyperinflation and left ventricular mass: The multi-ethnic study of atherosclerosis COPD study. Circulation, 127(14), 1503-1511. https://doi.org/10.1161/CIRCULATIONAHA.113.001653
Smith, Benjamin M. ; Kawut, Steven M. ; Bluemke, David A. ; Basner, Robert C. ; Gomes, Antoinette S. ; Hoffman, Eric ; Kalhan, Ravi ; Lima, João A.C. ; Liu, Chia Ying ; Michos, Erin D. ; Prince, Martin R. ; Rabbani, Leroy ; Rabinowitz, Daniel ; Shimbo, Daichi ; Shea, Steven ; Barr, R. Graham. / Pulmonary hyperinflation and left ventricular mass : The multi-ethnic study of atherosclerosis COPD study. In: Circulation. 2013 ; Vol. 127, No. 14. pp. 1503-1511.
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abstract = "Background-Left ventricular (LV) mass is an important predictor of heart failure and cardiovascular mortality, yet determinants of LV mass are incompletely understood. Pulmonary hyperinflation in chronic obstructive pulmonary disease (COPD) may contribute to changes in intrathoracic pressure that increase LV wall stress. We therefore hypothesized that residual lung volume in COPD would be associated with greater LV mass. Methods and Results-The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Study recruited smokers 50 to 79 years of age who were free of clinical cardiovascular disease. LV mass was measured by cardiac magnetic resonance. Pulmonary function testing was performed according to guidelines. Regression models were used to adjust for age, sex, body size, blood pressure, and other cardiac risk factors. Among 119 MESA COPD Study participants, the mean age was 69±6 years, 55{\%} were male, and 65{\%} had COPD, mostly of mild or moderate severity. Mean LV mass was 128±34 g. Residual lung volume was independently associated with greater LV mass (7.2 g per 1-SD increase in residual volume; 95{\%} confidence interval, 2.2-12; P=0.004) and was similar in magnitude to that of systolic blood pressure (7.6 g per 1-SD increase in systolic blood pressure; 95{\%} confidence interval, 4.3-11; P<0.001). Similar results were observed for the ratio of LV mass to end-diastolic volume (P=0.02) and with hyperinflation measured as residual volume to total lung capacity ratio (P=0.009). Conclusions-Pulmonary hyperinflation, as measured by residual lung volume or residual lung volume to total lung capacity ratio, is associated with greater LV mass.",
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Smith, BM, Kawut, SM, Bluemke, DA, Basner, RC, Gomes, AS, Hoffman, E, Kalhan, R, Lima, JAC, Liu, CY, Michos, ED, Prince, MR, Rabbani, L, Rabinowitz, D, Shimbo, D, Shea, S & Barr, RG 2013, 'Pulmonary hyperinflation and left ventricular mass: The multi-ethnic study of atherosclerosis COPD study', Circulation, vol. 127, no. 14, pp. 1503-1511. https://doi.org/10.1161/CIRCULATIONAHA.113.001653

Pulmonary hyperinflation and left ventricular mass : The multi-ethnic study of atherosclerosis COPD study. / Smith, Benjamin M.; Kawut, Steven M.; Bluemke, David A.; Basner, Robert C.; Gomes, Antoinette S.; Hoffman, Eric; Kalhan, Ravi; Lima, João A.C.; Liu, Chia Ying; Michos, Erin D.; Prince, Martin R.; Rabbani, Leroy; Rabinowitz, Daniel; Shimbo, Daichi; Shea, Steven; Barr, R. Graham.

In: Circulation, Vol. 127, No. 14, 09.04.2013, p. 1503-1511.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Pulmonary hyperinflation and left ventricular mass

T2 - The multi-ethnic study of atherosclerosis COPD study

AU - Smith, Benjamin M.

AU - Kawut, Steven M.

AU - Bluemke, David A.

AU - Basner, Robert C.

AU - Gomes, Antoinette S.

AU - Hoffman, Eric

AU - Kalhan, Ravi

AU - Lima, João A.C.

AU - Liu, Chia Ying

AU - Michos, Erin D.

AU - Prince, Martin R.

AU - Rabbani, Leroy

AU - Rabinowitz, Daniel

AU - Shimbo, Daichi

AU - Shea, Steven

AU - Barr, R. Graham

PY - 2013/4/9

Y1 - 2013/4/9

N2 - Background-Left ventricular (LV) mass is an important predictor of heart failure and cardiovascular mortality, yet determinants of LV mass are incompletely understood. Pulmonary hyperinflation in chronic obstructive pulmonary disease (COPD) may contribute to changes in intrathoracic pressure that increase LV wall stress. We therefore hypothesized that residual lung volume in COPD would be associated with greater LV mass. Methods and Results-The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Study recruited smokers 50 to 79 years of age who were free of clinical cardiovascular disease. LV mass was measured by cardiac magnetic resonance. Pulmonary function testing was performed according to guidelines. Regression models were used to adjust for age, sex, body size, blood pressure, and other cardiac risk factors. Among 119 MESA COPD Study participants, the mean age was 69±6 years, 55% were male, and 65% had COPD, mostly of mild or moderate severity. Mean LV mass was 128±34 g. Residual lung volume was independently associated with greater LV mass (7.2 g per 1-SD increase in residual volume; 95% confidence interval, 2.2-12; P=0.004) and was similar in magnitude to that of systolic blood pressure (7.6 g per 1-SD increase in systolic blood pressure; 95% confidence interval, 4.3-11; P<0.001). Similar results were observed for the ratio of LV mass to end-diastolic volume (P=0.02) and with hyperinflation measured as residual volume to total lung capacity ratio (P=0.009). Conclusions-Pulmonary hyperinflation, as measured by residual lung volume or residual lung volume to total lung capacity ratio, is associated with greater LV mass.

AB - Background-Left ventricular (LV) mass is an important predictor of heart failure and cardiovascular mortality, yet determinants of LV mass are incompletely understood. Pulmonary hyperinflation in chronic obstructive pulmonary disease (COPD) may contribute to changes in intrathoracic pressure that increase LV wall stress. We therefore hypothesized that residual lung volume in COPD would be associated with greater LV mass. Methods and Results-The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Study recruited smokers 50 to 79 years of age who were free of clinical cardiovascular disease. LV mass was measured by cardiac magnetic resonance. Pulmonary function testing was performed according to guidelines. Regression models were used to adjust for age, sex, body size, blood pressure, and other cardiac risk factors. Among 119 MESA COPD Study participants, the mean age was 69±6 years, 55% were male, and 65% had COPD, mostly of mild or moderate severity. Mean LV mass was 128±34 g. Residual lung volume was independently associated with greater LV mass (7.2 g per 1-SD increase in residual volume; 95% confidence interval, 2.2-12; P=0.004) and was similar in magnitude to that of systolic blood pressure (7.6 g per 1-SD increase in systolic blood pressure; 95% confidence interval, 4.3-11; P<0.001). Similar results were observed for the ratio of LV mass to end-diastolic volume (P=0.02) and with hyperinflation measured as residual volume to total lung capacity ratio (P=0.009). Conclusions-Pulmonary hyperinflation, as measured by residual lung volume or residual lung volume to total lung capacity ratio, is associated with greater LV mass.

KW - Chronic obstructive pulmonary disease

KW - Hyperinflation

KW - Left ventricular mass

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