Pulmonary function test abnormalities in the elderly with systolic heart failure

An association between chronic heart failure (CHF) and pulmonary function abnormalities is clinically important. Spirometry is frequently used to evaluate lung function.

To evaluate some spirometric parameters in the elderly with newly diagnosed or known systolic CHF.

The study group consisted of 110 patients (74 men-67.3%) who underwent echocardiography as well as spirometry with reversibility test. Heart failure was diagnosed using the guidelines of the European Society of Cardiology and Framingham criteria. The average age of the patients was 68.5+/-8.9 years. Smokers constituted 54.5% of the group. Concomitant diseases included arterial hypertension (86.4%), diabetes type 2 (20.9%), and myocardial infarction (49.1%). At the beginning of the study, 54.5% of the patients had already been taking beta-blockers, 84.5% angiotensin-converting enzyme inhibitors, 83.6% diuretics, 30% calcium channel blockers, and 92.7% aspirin. Echocardiography revealed left ventricular ejection fraction (LVEF) below 45% in 74 (67.3%) patients.

All analysed spirometric parameters were abnormal in CHF patients. A multivariable analysis revealed that age, smoking and LVEF were the only independent parameters which significantly effected FEV1--one of the most important spirometric parameters.

In patients with systolic CHF, independently of the treatment, mixed ventilation disorders were observed, which had a positive reversibility test. Apart from impaired LVEF, older age as well as smoking significantly influenced the deterioration of ventilatory parameters.