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Use of vital capacity for cardiac failure risk estimation in persons with coronary disease and left ventricular
W B Kannel1, R B D'Agostino, H Silbershatz
1Department of Medicine, Evans Memorial Research Foundation, Boston, Massachusetts, USA.
Insights
Low forced vital capacity (FVC) significantly predicts cardiac failure risk in individuals with coronary heart disease or left ventricular hypertrophy. This simple lung function test aids early identification of at-risk patients.
Area of Science:
- Cardiology
- Pulmonology
- Preventive Medicine
Background:
- Cardiac failure is a major cause of death, often stemming from coronary heart disease and left ventricular hypertrophy.
- Identifying individuals at high risk for cardiac failure is crucial for timely intervention.
Purpose of the Study:
- To evaluate the predictive value of forced vital capacity (FVC) for cardiac failure onset.
- To determine if FVC can identify individuals predisposed to cardiac failure due to coronary heart disease or left ventricular hypertrophy.
Main Methods:
- Analysis of biennial FVC measurements in 818 Framingham Study participants.
- Comparison of cardiac failure incidence between quartiles of FVC in subjects with predisposing conditions.
Main Results:
- Individuals in the lowest FVC quartile showed substantially increased risk for cardiac failure.
- Men with lowest FVC had 1.8 times the risk; women had 2.3 times the risk compared to highest FVC quartiles.
- The predictive value of low FVC was consistent across coronary disease and left ventricular hypertrophy groups.
Conclusions:
- Forced vital capacity (FVC) is an inexpensive and effective predictor of cardiac failure in predisposed individuals.
- FVC measurement can help identify patients who may benefit from further cardiac evaluation, such as echocardiography.
Abstract:
Cardiac failure is a common lethal outcome of coronary heart disease and left ventricular hypertrophy. The efficacy of forced vital capacity (FVC), measured biennially, in predicting the onset of cardiac failure was explored in 818 Framingham Study subjects with those predisposing conditions, among 324 developed cardiac failure. Among the men and women who had coronary disease or left ventricular hypertrophy, those with FVCs in the lower quartile were at substantially increased risk of developing cardiac failure. For men, comparing the lowest quartile with men whose FVCs were in the highest quartile (<2.7 L vs >5.6 L), the risk ratio was 1.8; for women with FVCs <1.7 L, the risk was 2.3 times those with FVCs of > or = 3.5L. The excess risk of cardiac failure imposed by a low FVC was similar in those with coronary disease and left ventricular hypertrophy. The simple FVC is an inexpensive and robust predictor of cardiac failure in persons predisposed by coronary disease or left ventricular hypertrophy. FVC determination should help identify candidates for cardiac failure needing echocardiographic examination for ventricular dysfunction.